Background Segond’s fracture is a well-recognised radiologicalsign of an anterior cruciate ligament (ACL) tear.While previous studies evaluated the role of the anterolateralligament (ALL) and complex injuries on rotationalstability of the knee, there are no studies on the biomechanicaleffect of Segond’s fracture in an ACL deficientknee. The aim of this study was to evaluate the effect of aSegond’s fracture on knee rotation stability as evaluated bya navigation system in an ACL deficient knee.Materials and methods Three different conditions weretested on seven knee specimens: intact knee, ACL deficientknee and ACL deficient knee with Segond’s fracture. Staticand dynamic measurements of anterior tibial translation(ATT) and axial tibial rotation (ATR) were recorded by thenavigation system (2.2 OrthoPilot ACL navigation systemB. Braun Aesculap, Tuttlingen, Germany).Results Static measurements at 30 showed that the meanATT at 30 of knee flexion was 5.1 ± 2.7 mm in the ACLintact condition, 14.3 ± 3.1 mm after ACL cut(P = 0.005), and 15.2 ± 3.6 mm after Segond’s fracture(P = 0.08). The mean ATR at 30 of knee flexion was20.7 ± 4.8 in the ACL intact condition, 26.9 ± 4.1 inthe ACL deficient knee (P[0.05) and 30.9 ± 3.8 afterSegond’s fracture (P = 0.005). Dynamic measurementsduring the pivot-shift showed that the mean ATT was7.2 ± 2.7 mm in the intact knee, 9.1 ± 3.3 mm in theACL deficient knee(P = 0.04) and 9.7 ± 4.3 mm in theACL deficient knee with Segond’s fracture (P = 0.07).The mean ATR was 9.6 ± 1.8 in the intact knee,12.3 ± 2.3 in the ACL deficient knee (P[0.05) and19.1 ± 3.1 in the ACL deficient knee with Segond’slesion (P = 0.016).Conclusion An isolated lesion of the ACL only affectsATT during static and dynamic measurements, while theaddition of Segond’s fracture has a significant effect onATR in both static and dynamic execution of the pivot-shifttest, as evaluated with the aid of navigation.
Segond's fracture: a biomechanical cadaveric study using navigation
Guzzini, M.;
2017-01-01
Abstract
Background Segond’s fracture is a well-recognised radiologicalsign of an anterior cruciate ligament (ACL) tear.While previous studies evaluated the role of the anterolateralligament (ALL) and complex injuries on rotationalstability of the knee, there are no studies on the biomechanicaleffect of Segond’s fracture in an ACL deficientknee. The aim of this study was to evaluate the effect of aSegond’s fracture on knee rotation stability as evaluated bya navigation system in an ACL deficient knee.Materials and methods Three different conditions weretested on seven knee specimens: intact knee, ACL deficientknee and ACL deficient knee with Segond’s fracture. Staticand dynamic measurements of anterior tibial translation(ATT) and axial tibial rotation (ATR) were recorded by thenavigation system (2.2 OrthoPilot ACL navigation systemB. Braun Aesculap, Tuttlingen, Germany).Results Static measurements at 30 showed that the meanATT at 30 of knee flexion was 5.1 ± 2.7 mm in the ACLintact condition, 14.3 ± 3.1 mm after ACL cut(P = 0.005), and 15.2 ± 3.6 mm after Segond’s fracture(P = 0.08). The mean ATR at 30 of knee flexion was20.7 ± 4.8 in the ACL intact condition, 26.9 ± 4.1 inthe ACL deficient knee (P[0.05) and 30.9 ± 3.8 afterSegond’s fracture (P = 0.005). Dynamic measurementsduring the pivot-shift showed that the mean ATT was7.2 ± 2.7 mm in the intact knee, 9.1 ± 3.3 mm in theACL deficient knee(P = 0.04) and 9.7 ± 4.3 mm in theACL deficient knee with Segond’s fracture (P = 0.07).The mean ATR was 9.6 ± 1.8 in the intact knee,12.3 ± 2.3 in the ACL deficient knee (P[0.05) and19.1 ± 3.1 in the ACL deficient knee with Segond’slesion (P = 0.016).Conclusion An isolated lesion of the ACL only affectsATT during static and dynamic measurements, while theaddition of Segond’s fracture has a significant effect onATR in both static and dynamic execution of the pivot-shifttest, as evaluated with the aid of navigation.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
