Department of Orthopedic Surgery, New York University Langone Health, 333 East 38th St, New York, NY, 10016, USA.
Division of Orthopedic Surgery, Tel-Hashomer "Sheba" Medical Center, Tel-Aviv University, Ramat Gan, Israel.
Eur J Orthop Surg Traumatol. 2024 May;34(4):1883-1891. doi: 10.1007/s00590-024-03857-2. Epub 2024 Mar 6.
The purpose of this study was to investigate the incidence and anatomic distribution of meniscus injury in patients who have sustained acute ACL injuries with and without concomitant Segond fracture. We hypothesized that patients who have sustained a torn ACL with a concomitant Segond fracture would have a higher incidence of lateral meniscal injuries than patients with an isolated ACL injury.
Patients who underwent ACL reconstruction from 2012 to 2022 were retrospectively reviewed. Segond fractures were identified on knee radiographs. Inclusion criteria were age 18-40, injury during sports activity, and reconstruction within 90 days of injury. Sports activity, anatomic location of meniscus injury, and meniscus treatment were documented. Multivariable regression was used to identify predictors of meniscus injury/treatment.
There were 25 of 603 (4.1%) patients who had an ACL tear with concomitant Segond fracture. The incidence of lateral meniscus injury in the Segond group (72%) was significantly higher than in the non-Segond cohort (49%; p = 0.024). A significantly smaller proportion of medial meniscus injuries among patients with Segond fractures were repaired (23.1%) compared to the non-Segond group (54.2%; p = 0.043). Multivariate analysis found patients with Segond fractures to have increased odds of lateral meniscus injury (OR 2.68; [1.09, 6.60], p = 0.032) and were less likely to have medial meniscus injuries repaired (OR 0.35; [0.15, 0.81], p = 0.014). Additionally, males had increased odds of lateral meniscus injury (OR 1.54; [1.08 - 2.91], p = 0.017), which were more likely to require repair (OR 1.48; [1.02, 2.14], p = 0.038).
Among acute ACL injuries, the incidence of lateral meniscus injury is greater among patients with Segond fractures. Patients with Segond fracture were less likely to undergo repair of medial meniscal injuries.
本研究旨在探讨伴有和不伴有 Segond 骨折的急性 ACL 损伤患者半月板损伤的发生率和解剖分布。我们假设，与单纯 ACL 损伤相比，伴有 Segond 骨折的 ACL 撕裂患者的外侧半月板损伤发生率更高。
回顾性分析 2012 年至 2022 年接受 ACL 重建的患者。在膝关节 X 线片上识别 Segond 骨折。纳入标准为年龄 18-40 岁、运动中受伤和受伤后 90 天内重建。记录运动活动、半月板损伤的解剖位置和半月板治疗情况。采用多变量回归分析确定半月板损伤/治疗的预测因素。
603 例患者中有 25 例（4.1%）ACL 撕裂合并 Segond 骨折。Segond 组（72%）外侧半月板损伤的发生率明显高于非 Segond 组（49%；p=0.024）。Segond 骨折患者中内侧半月板损伤接受修复的比例明显较小（23.1%），而非 Segond 组为（54.2%；p=0.043）。多变量分析发现，Segond 骨折患者发生外侧半月板损伤的可能性增加（OR 2.68；[1.09，6.60]，p=0.032），内侧半月板损伤接受修复的可能性降低（OR 0.35；[0.15，0.81]，p=0.014）。此外，男性发生外侧半月板损伤的可能性增加（OR 1.54；[1.08-2.91]，p=0.017），且更有可能需要修复（OR 1.48；[1.02，2.14]，p=0.038）。
在急性 ACL 损伤中，伴有 Segond 骨折的患者外侧半月板损伤的发生率更高。伴有 Segond 骨折的患者内侧半月板损伤更不可能接受修复。
