BACKGROUND The Segond fracture is an avulsion of the anterolateral tibia that can be found in patients with an anterior cruciate ligament (ACL) tear. It is currently unclear if the Segond fracture needs treatment or if it heals spontaneously and if it is associated with an increased risk of failure after ACL reconstruction. PURPOSE To identify the incidence and spontaneous healing rate of Segond fractures in a consecutive cohort of patients undergoing ACL reconstruction and to examine the predictive value of the Segond fracture on the risk of undergoing revision surgery. STUDY DESIGN Cohort study; Level of evidence, 3. METHODS A retrospective review of a cohort undergoing isolated ACL reconstruction between 2002 and 2016 was performed. Radiographs from the time of injury and preoperative radiographs were evaluated for Segond fractures and healed Segond fractures. Descriptive data were extracted from an internal quality database. Statistical analyses were performed to investigate risk of revision surgery and to compare across subgroups of patients. RESULTS A total of 1364 patients were included in the study. The incidence of Segond fractures was 7.4%. In addition, 10.4% of patients displayed signs of healed Segond fractures. In total, 15.2% of patients had either 1 or both findings. The overall healing response of the fracture was 35.6%. Those with Segond fractures were older (P = .014) and had a shorter interval from injury to surgery (P = .003) as compared with the rest of the cohort. The incidence of Segond fractures was significantly higher in those injured during downhill skiing as compared with other injury mechanisms (P = .04). The Segond fracture did not represent an increased risk of undergoing revision when compared with the control group (not significant). CONCLUSION The incidence of conventional Segond fractures in patients with ACL injury was found to be in accordance with former studies. Accounting for the high incidence of healed Segond fractures, a much higher incidence (15%) was seen. Although the spontaneous healing rate from initial radiographs to preoperative imaging was only 36%, the presence of Segond fractures did not represent a higher risk of undergoing revision surgery.

中文翻译：

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前交叉韧带重建术患者的先天性骨折发病率和预后意义。

背景Segond骨折是前交叉韧带撕脱，可在前交叉韧带（ACL）撕裂患者中发现。目前尚不清楚Segond骨折是否需要治疗或是否能自愈，以及是否与ACL重建后失败的风险增加有关。目的确定连续进行ACL重建的患者队列中Segond骨折的发生率和自发愈合率，并检查Segond骨折对翻修手术风险的预测价值。研究设计队列研究；证据水平，3。方法对2002年至2016年间接受单独ACL重建的队列进行回顾性回顾。评估了Segond骨折和愈合的Segond骨折后的射线照片和术前X射线照片。描述性数据是从内部质量数据库中提取的。进行统计分析以调查翻修手术的风险并比较患者亚组。结果研究共纳入1364例患者。Segond骨折的发生率为7.4％。此外，有10.4％的患者表现出Segond骨折愈合的迹象。总共有15.2％的患者有1个或全部2个发现。骨折的总体愈合反应为35.6％。与其他人群相比，患有Segond骨折的人年龄更大（P = .014），从受伤到手术的时间间隔更短（P = .003）。与其他损伤机制相比，在下坡滑雪期间受伤的人中Segond骨折的发生率显着更高（P = .04）。与对照组相比，Segond骨折并不代表接受翻修的风险增加（不显着）。结论ACL损伤患者常规Segond骨折的发生率与以前的研究一致。考虑到治愈的Segond骨折的高发生率，发现的发生率更高（15％）。尽管从最初的X线片到术前影像的自发愈合率仅为36％，但Segond骨折的存在并不代表接受翻修手术的较高风险。与对照组相比，Segond骨折并不代表接受翻修的风险增加（不显着）。结论ACL损伤患者常规Segond骨折的发生率与以前的研究一致。考虑到治愈的Segond骨折的高发生率，发现的发生率更高（15％）。尽管从最初的X光片到术前影像的自发愈合率仅为36％，但Segond骨折的存在并不代表接受翻修手术的较高风险。与对照组相比，Segond骨折并不代表接受翻修的风险增加（不显着）。结论ACL损伤患者常规Segond骨折的发生率与以前的研究一致。考虑到治愈的Segond骨折的高发生率，发现的发生率更高（15％）。尽管从最初的X线片到术前影像的自发愈合率仅为36％，但Segond骨折的存在并不代表接受翻修手术的较高风险。发生率更高（15％）。尽管从最初的X线片到术前影像的自发愈合率仅为36％，但Segond骨折的存在并不代表接受翻修手术的较高风险。发生率更高（15％）。尽管从最初的X线片到术前影像的自发愈合率仅为36％，但Segond骨折的存在并不代表接受翻修手术的较高风险。