A 26-year-old footballer twists his knee and presents with acute hemarthrosis. Radiographs show a small vertical bony avulsion fragment from the lateral margin of the lateral tibial plateau just below the joint line. MRI confirms a mid-substance rupture of the ACL. This avulsion fracture is termed:

• A Fleck sign lesion
• B Deep notch sign
• C Arcuate sign
• D Segond fracture ✓

Explanation

The Segond fracture is a cortical avulsion from the anterolateral aspect of the lateral tibial plateau, classically attributed to the anterolateral ligament or mid-third lateral capsule, and is strongly associated with ACL rupture in roughly three quarters of cases. It signals internal rotation-varus loading. The arcuate sign is the posteromedial fibular head avulsion of the posterolateral corner structures, an entirely different avulsion site.

Reference: Rockwood and Green's Fractures in Adults, 9th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.