Campos J C, Chung C B, Lektrakul N, Pedowitz R, Trudell D, Yu J, Resnick D
Department of Radiology, Veterans Affairs Medical Center, University of California, 3350 La Jolla Village Dr, San Diego, CA 92161, USA.
Radiology. 2001 May;219(2):381-6. doi: 10.1148/radiology.219.2.r01ma23381.
To demonstrate the normal anatomy of the stabilizing structures of the lateral aspect of the knee and to investigate pathogenesis of the Segond fracture, with emphasis on the iliotibial tract (ITT) and anterior oblique band (AOB) of the fibular collateral ligament.
Dissection of the region of the AOB, ITT, and lateral capsular ligament was performed in three cadaveric knees, with placement of gadopentetate dimeglumine-filled tubes along their course and tibial insertions. These knees, in addition to three nondissected knees, were studied with magnetic resonance (MR) imaging by using standard and specialized oblique planes. Specimen sectioning provided anatomic correlation. Retrospective review of radiographs and MR images in 17 patients with acute Segond fractures was performed, and the relationship between the fragment and the demonstrated lateral supporting structures of the knee was noted.
Anatomic dissection and MR imaging of the cadaveric knees demonstrated a broad tibial insertion of the ITT, with fibers extending posterior to the Gerdy tubercle. A firm band of tissue, the AOB, extended from the fibular collateral ligament to the midportion of the lateral tibia, the typical site of a Segond fracture. The lateral capsular ligament proved to be a mere thickening of the capsule, inserting at the lateral tibia. Clinical analysis of acute Segond fractures confirmed the frequent attachment of the ITT and AOB to the avulsed fragment.
Anatomic and clinical findings suggest that fibers of the ITT and AOB are important factors in the pathogenesis of the Segond fracture.
展示膝关节外侧稳定结构的正常解剖，并研究Segond骨折的发病机制，重点关注髂胫束（ITT）和腓侧副韧带的前斜束（AOB）。
对三个尸体膝关节进行AOB、ITT和外侧关节囊韧带区域的解剖，沿其走行和胫骨附着处放置装有钆喷酸葡胺的导管。除了三个未解剖的膝关节外，还使用标准和特殊斜位平面通过磁共振（MR）成像对这些膝关节进行研究。标本切片提供了解剖学对照。对17例急性Segond骨折患者的X线片和MR图像进行回顾性分析，记录骨折块与所显示的膝关节外侧支持结构之间的关系。
尸体膝关节的解剖和MR成像显示ITT在胫骨上的附着广泛，其纤维延伸至Gerdy结节后方。一条坚实的组织带，即AOB，从腓侧副韧带延伸至胫骨外侧中部，即Segond骨折的典型部位。外侧关节囊韧带被证明只是关节囊的增厚，附着于胫骨外侧。急性Segond骨折的临床分析证实ITT和AOB经常附着于撕脱骨折块。
解剖学和临床研究结果表明，ITT和AOB的纤维是Segond骨折发病机制中的重要因素。
