Tibial plateau on lateral aspect shows subtle ill definition and distal tibia below the plateau is unremarkable with no definite avulsion fragment away from the bone even on tunnel view (superior to AP view) and hence it is possibly normal gerdy tubercle and does not represent segond’s fracture, however, if clinically relevant MRI would help exclude segond’s and associated injuries. Case submitted by –Dr MGK Murthy.
Teaching points
Lateral tibial avulsion fracture is referred to as segonds fracture ( eponym being named after Dr Paul Segond). Originally thought to be a result of avulsion of the medial third of the lateral collateral ligament, more recent research suggests that the insertion of the iliotibial tract (ITT) and the anterior oblique band (AOB), a ligamentous attachment of the fibular collateral ligament to the midportion of the lateral tibia, also play an important role. Associations ACL tear(75 to 100%), any of the meniscus(66 to 70%), avulsion of the fibular head fracture, avulsion of gerdy tubercle. Avulsion fracture of medial collateral ligament associated with PCL and medial meniscus injuries is referred to as reverse segond’s fracture
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