Reverse Segond Fracture Associated with Anteromedial Tibial Rim and Tibial Attachment of Anterior Cruciate Ligament Avulsion Fractures.

Case Rep Orthop

Orthopedic Surgery Department, El-Hadara University Hospital, University of Alexandria, Alexandria, Egypt.

Published: August 2017

Reverse Segond fracture is an uncommon avulsion fracture of the tibial attachment of the deep portion of the medial collateral ligament of the knee. We report a reverse Segond fracture associated with anterior cruciate ligament tibial avulsion fracture and anteromedial tibial rim fracture. Unlike previous reports, the combination of reverse Segond fracture, anteromedial tibial rim fracture, and anterior cruciate ligament avulsion fracture was not associated with posterior cruciate ligament injury, posterolateral corner injury, or tibial plateau fracture. This new combination of injuries provides better understanding of the mechanisms of ligamentous injuries of the knee and highlights the importance of meticulous assessment of these injuries for accurate diagnosis and subsequent management.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5603135PMC
http://dx.doi.org/10.1155/2017/9637153DOI Listing

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Article Synopsis
  • The authors discuss three cases of isolated deep medial collateral ligament (dMCL) injuries, highlighting their rarity and the need for proper treatment guidelines.
  • The injuries involved a soft-tissue avulsion, a bony avulsion, and a newly described "reverse Segond" fracture, all caused by extreme knee joint rotation.
  • All patients underwent a similar treatment plan involving a knee brace and physical therapy, leading to successful recovery and regaining of knee function.
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Mechanical ventilation during cardiopulmonary resuscitation: influence of positive end-expiratory pressure and head-torso elevation.

Resuscitation

April 2023

Emergency Department and Mobile Intensive Care Unit, University Hospital of Grenoble Alpes, Grenoble, France; Univ. Grenoble Alpes, CNRS, UMR 5525, VetAgro Sup, Grenoble INP, TIMC, 38000 Grenoble, France.

Background: Efficient ventilation is important during cardiopulmonary resuscitation (CPR). Nevertheless, there is insufficient knowledge on how the patient's position affects ventilatory parameters during mechanically assisted CPR. We studied ventilatory parameters at different positive end-expiratory pressure (PEEP) levels and when using an inspiratory impedance valve (ITD) during horizontal and head-up CPR (HUP-CPR).

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Introduction: Reverse Segond fracture is a cortical avulsion fracture off the medial tibial plateau of the knee, associated with tears of the posterior cruciate ligament (PCL), medial collateral ligament (MCL), medial meniscus, and probably the anterior cruciate ligament (ACL). Unlike Segond fracture, it is a very rare injury of the knee.

Case Report: Case one is a 24-year-old male with left tibial plateau and reverse Segond fracture with an magnetic resonance imaging (MRI) showing MCL avulsion, medial meniscus entrapped in fracture site and ACL tear but intact PCL.

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To listen to the podcast associated with this article, please select one of the following: iTunes or Google Play. The purpose of this article is to describe Stener-like lesions of the superficial medial collateral ligament (sMCL) of the knee, which, to our knowledge, have not yet been reported in the radiologic literature. This lesion, defined as a distal tear with interposition of osseous or soft-tissue structures between the ligament and its tibial attachment, often requires surgical intervention.

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Reverse Segond fracture is an uncommon avulsion fracture of the tibial attachment of the deep portion of the medial collateral ligament of the knee. We report a reverse Segond fracture associated with anterior cruciate ligament tibial avulsion fracture and anteromedial tibial rim fracture. Unlike previous reports, the combination of reverse Segond fracture, anteromedial tibial rim fracture, and anterior cruciate ligament avulsion fracture was not associated with posterior cruciate ligament injury, posterolateral corner injury, or tibial plateau fracture.

View Article and Find Full Text PDF

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