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Combined osteochondral fracture of the posterolateral tibial plateau and Segond fracture with anterior cruciate ligament injury in a skeletally immature patient

  • Knee
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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

A case of a 14-year-old boy with a rare injury—an osteochondral fracture of the posterolateral tibial plateau associated with the anterior cruciate ligament (ACL) rapture, and Segond fracture characterized by an avulsion fracture of the lateral tibial plateau—is reported. This case was noteworthy because it involved a rare combination of ACL injuries. This injury was thought to be caused by the impaction between the posterior aspect of the lateral tibial plateau and the lateral femoral condyle during internal rotational displacement of the knee joint at the time of injury, because the osteochondral fracture of the posterolateral tibial plateau matched the site where the bone bruise was observed.

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References

  1. Beynnon BD, Johnson RJ, Abate JA, Fleming BC, Nichols CE (2005) Treatment of anterior cruciate ligament injuries, part I. Am J Sports Med 33(10):1579–1602

    Article  PubMed  Google Scholar 

  2. Bjordal JM, Arnly F, Hannestad B, Strand T (1997) Epidemiology of anterior cruciate ligament injuries in soccer. Am J Sports Med 25(3):341–345

    Article  PubMed  CAS  Google Scholar 

  3. Bovid KM, Salata MJ, Vander Have KL, Sekiya JK (2010) Arthroscopic posterior cruciate ligament reconstruction in a skeletally immature patient: a new technique with case report. Arthroscopy 26(4):563–570

    Article  PubMed  Google Scholar 

  4. Chan KK, Resnick D, Goodwin D, Seeger LL (1999) Posteromedial tibial plateau injury including avulsion fracture of the semimembranous tendon insertion site: ancillary sign of anterior cruciate ligament tear at MR imaging. Radiology 211(3):754–758

    PubMed  CAS  Google Scholar 

  5. Cobby MJ, Schweitzer ME, Resnick D (1992) The deep lateral femoral notch: an indirect sign of a torn anterior cruciate ligament. Radiology 184(3):855–858

    PubMed  CAS  Google Scholar 

  6. Davis DS, Post WR (1997) Segond fracture: lateral capsular ligament avulsion. J Orthop Sports Phys Ther 25(2):103–106

    PubMed  CAS  Google Scholar 

  7. Garth WP Jr, Greco J, House MA (2000) The lateral notch sign associated with acute anterior cruciate ligament disruption. Am J Sports Med 28(1):68–73

    PubMed  Google Scholar 

  8. Hess T, Rupp S, Hopf T, Gleitz M, Liebler J (1994) Lateral tibial avulsion fractures and disruptions to the anterior cruciate ligament. A clinical study of their incidence and correlation. Clin Orthop Relat Res 303:193–197

    PubMed  Google Scholar 

  9. Johnson DL, Bealle DP, Brand JC Jr, Nyland J, Caborn DN (2000) The effect of a geographic lateral bone bruise on knee inflammation after acute anterior cruciate ligament rupture. Am J Sports Med 28(2):152–155

    PubMed  CAS  Google Scholar 

  10. Johnson R (1998) The knee. In: Harries M, Williams C, Stanish WD et al (eds) Oxford textbook of sports medicine, 2nd edn. Oxford, NY, pp 411–419

    Google Scholar 

  11. Kaplan PA, Gehl RH, Dussault RG, Anderson MW, Diduch DR (1999) Bone contusions of the posterior lip of the medial tibial plateau (contrecoup injury) and associated internal derangements of the knee at MR imaging. Radiology 211(3):747–753

    PubMed  CAS  Google Scholar 

  12. Kaplan PA, Walker CW, Kilcoyne RF, Brown DE, Tusek D, Dussault RG (1992) Occult fracture patterns of the knee associated with anterior cruciate ligament tears: assessment with MR imaging. Radiology 183(3):835–838

    PubMed  CAS  Google Scholar 

  13. Kezdi-Rogus PC, Lomasney LM (1994) Radiologic case study. Plain film manifestations of ACL injury. Orthopedics 17(10):967–973

    PubMed  CAS  Google Scholar 

  14. Kode L, Lieberman JM, Motta AO, Wilber JH, Vasen A, Yagan R (1994) Evaluation of tibial plateau fractures: efficacy of MR imaging compared with CT. AJR Am J Roentgenol 163(1):141–147

    PubMed  CAS  Google Scholar 

  15. Matsumoto H (1990) Mechanism of the pivot shift. J Bone Jt Surg Br 72(5):816–821

    CAS  Google Scholar 

  16. McCauley TR, Moses M, Kier R, Lynch JK, Barton JW, Jokl P (1994) MR diagnosis of tears of anterior cruciate ligament of the knee: importance of ancillary findings. AJR Am J Roentgenol 162(1):115–119

    PubMed  CAS  Google Scholar 

  17. Milgram JW, Rogers LF, Miller JW (1978) Osteochondral fractures: mechanisms of injury and fate of fragments. AJR Am J Roentgenol 130(4):651–658

    PubMed  CAS  Google Scholar 

  18. Mitsou A, Vallianatos P (1988) Meniscal injuries associated with rupture of the anterior cruciate ligament: a retrospective study. Injury 19(6):429–431

    Article  PubMed  CAS  Google Scholar 

  19. Murphy BJ, Smith RL, Uribe JW, Janecki CJ, Hechtman KS, Mangasarian RA (1992) Bone signal abnormalities in the posterolateral tibia and lateral femoral condyle in complete tears of the anterior cruciate ligament: a specific sign? Radiology 182(1):221–224

    PubMed  CAS  Google Scholar 

  20. Nakauchi M, Kurosawa H, Kawakami A (2000) Abnormal lateral notch in knees with anterior cruciate ligament injury. J Orthop Sci 5(2):92–95

    Article  PubMed  CAS  Google Scholar 

  21. Rorabeck CH, Bobechko WP (1976) Acute dislocation of the patella with osteochondral fracture: a review of 18 cases. J Bone Jt Surg Br 58(2):237–240

    CAS  Google Scholar 

  22. Rosen MA, Jackson DW, Berger PE (1991) Occult osseous lesions documented by magnetic resonance imaging associated with anterior cruciate ligament ruptures. Arthroscopy 7(1):45–51

    Article  PubMed  CAS  Google Scholar 

  23. Salzmann GM, Spang JT, Imhoff AB (2009) Double-bundle anterior cruciate ligament reconstruction in a skeletally immature adolescent athlete. Arthroscopy 25(3):321–324

    Article  PubMed  Google Scholar 

  24. Shelbourne KD, Nitz PA (1991) The O’Donoghue triad revisited. Combined knee injuries involving anterior cruciate and medial collateral ligament tears. Am J Sports Med 19(5):474–477

    Article  PubMed  CAS  Google Scholar 

  25. Slauterbeck JR, Kousa P, Clifton BC, Naud S, Tourville TW, Johnson RJ, Beynnon BD (2009) Geographic mapping of meniscus and cartilage lesions associated with anterior cruciate ligament injuries. J Bone Jt Surg Am 91(9):2094–2103

    Article  Google Scholar 

  26. Spindler KP, Schils JP, Bergfeld JA, Andrish JT, Weiker GG, Anderson TE, Piraino DW, Richmond BJ, Medendorp SV (1993) Prospective study of osseous, articular, and meniscal lesions in recent anterior cruciate ligament tears by magnetic resonance imaging and arthroscopy. Am J Sports Med 21(4):551–557

    Article  PubMed  CAS  Google Scholar 

  27. Stallenberg B, Gevenois PA, Sintzoff SA Jr, Matos C, Andrianne Y, Struyven J (1993) Fracture of the posterior aspect of the lateral tibial plateau: radiographic sign of anterior cruciate ligament tear. Radiology 187(3):821–825

    PubMed  CAS  Google Scholar 

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Acknowledgments

We would like to thank Ms. Janina Tubby for her assistance in editing this manuscript.

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Correspondence to Ryosuke Kuroda.

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Tei, K., Kubo, S., Matsumoto, T. et al. Combined osteochondral fracture of the posterolateral tibial plateau and Segond fracture with anterior cruciate ligament injury in a skeletally immature patient. Knee Surg Sports Traumatol Arthrosc 20, 252–255 (2012). https://doi.org/10.1007/s00167-011-1533-x

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