A tibial plateau fracture in a knee dislocation: A subtle sign of major ligamentous disruption

Department of Fractures and Orthopaedics, Royal Victoria Hospital, Grosvenor Road, Belfast BT12 6BA, Northern Ireland, UK.
Injury (Impact Factor: 2.14). 10/2004; 35(9):945-7. DOI: 10.1016/j.injury.2004.01.013
Source: PubMed
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    • "This fracture is pathognomonic of a torn anterior cruciate ligament [53]. Many studies have shown that a Segond fracture is associated with tearing the ACL in 75 to 100% of cases [54] [55]. "
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    ABSTRACT: When faced with a clinical suspicion of knee ligament injury, MRI nowadays has a central role in the diagnostic strategy. In particular, it is essential for assessing the cruciate ligaments and any associated meniscal tears. The objective of this review is to present the various direct and indirect MRI signs of tearing of the anterior cruciate ligament (ACL) and then describe the lesions associated with it. The anatomical and clinical aspects are also discussed so that the contribution of MRI to the diagnosis and therapeutic management of an ACL tear can be better understood.
    Preview · Article · Apr 2012 · Diagnostic and interventional imaging
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    ABSTRACT: We report two cases of marginal fractures of the medial tibial plateau associated with medial meniscal root tears. Both patients sustained knee dislocations, with complete tears of the posterior horn medial meniscal root. One sustained a "reverse Segond fracture"; the other sustained an "anteromedial impingement fracture" of the tibial plateau. The meniscal root tears were arthroscopically confirmed and repaired. In the first patient, the integrity of the meniscal root repair was confirmed at a 6-month follow-up arthroscopy for lysis of adhesions. In the second patient, follow-up MRI at 10 months demonstrated a healed meniscal root. The association of medial meniscal root tear with marginal fractures of the medial tibial plateau has not been previously reported.
    Full-text · Article · Feb 2007 · Skeletal Radiology
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    ABSTRACT: : Fractures of the medial plateau are associated with significant soft tissue injuries. A predictive measure of which medial plateau fractures are at higher risk of associated injuries has not been described. The authors propose a simple classification that is both easy to remember, recognize, and predictive of associated injuries. A type A fracture is where the fracture line is medial to the intercondylar spines, a type B is where the fracture line is within the intercondylar spines, and a type C fracture is where the fracture line is lateral to the intercondylar spines. : All patients treated at a Level I trauma center for tibial plateau fractures between 1998 and 2005 were identified. The radiographs of these patients were reviewed, and 28 patients were included in the study. The medical charts were then reviewed, and any associated injuries were noted. The patients were placed into one of three groups based on their fracture pattern. : Of the seven type A fractures, there was one patient with compartment syndrome (14%) and another with an ACL tear and medial meniscal tear. Of the 12 type B fractures, there were four patients with compartment syndrome (33%) and one with an ACL avulsion and medial meniscal tear. Of the nine type C fractures, there were six patients with compartment syndrome (67%), one of these also had a peroneal nerve injury, and another patient had an anterior tibial artery injury that required vascular surgery intervention. : As the fracture line moves laterally the severity of the associated injuries increases. We think it is significant that the only neurologic and vascular injuries seen were in the type C fractures. Also, we noted an increase propensity for type C fractures to develop compartment syndrome. This information can be helpful during the initial evaluation of the patient so that the physician can be wary of these developing problems.
    No preview · Article · Jan 2008 · The Journal of trauma
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