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Segond’s fracture: a biomechanical cadaveric study using navigation

BACKGROUND: Segond’s fracture is a well-recognised radiological sign of an anterior cruciate ligament (ACL) tear. While previous studies evaluated the role of the anterolateral ligament (ALL) and complex injuries on rotational stability of the knee, there are no studies on the biomechanical effect o...

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Autores principales: Monaco, E., Mazza, Daniele, Redler, A., Lupariello, D., Lanzetti, R., Guzzini, M., Ferretti, A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5685979/
https://www.ncbi.nlm.nih.gov/pubmed/28707122
http://dx.doi.org/10.1007/s10195-017-0460-0
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author Monaco, E.
Mazza, Daniele
Redler, A.
Lupariello, D.
Lanzetti, R.
Guzzini, M.
Ferretti, A.
author_facet Monaco, E.
Mazza, Daniele
Redler, A.
Lupariello, D.
Lanzetti, R.
Guzzini, M.
Ferretti, A.
author_sort Monaco, E.
collection PubMed
description BACKGROUND: Segond’s fracture is a well-recognised radiological sign of an anterior cruciate ligament (ACL) tear. While previous studies evaluated the role of the anterolateral ligament (ALL) and complex injuries on rotational stability of the knee, there are no studies on the biomechanical effect of Segond’s fracture in an ACL deficient knee. The aim of this study was to evaluate the effect of a Segond’s fracture on knee rotation stability as evaluated by a navigation system in an ACL deficient knee. MATERIALS AND METHODS: Three different conditions were tested on seven knee specimens: intact knee, ACL deficient knee and ACL deficient knee with Segond’s fracture. Static and dynamic measurements of anterior tibial translation (ATT) and axial tibial rotation (ATR) were recorded by the navigation system (2.2 OrthoPilot ACL navigation system B. Braun Aesculap, Tuttlingen, Germany). RESULTS: Static measurements at 30° showed that the mean ATT at 30° of knee flexion was 5.1 ± 2.7 mm in the ACL intact 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 was 20.7° ± 4.8° in the ACL intact condition, 26.9° ± 4.1° in the ACL deficient knee (P > 0.05) and 30.9° ± 3.8° after Segond’s fracture (P = 0.005). Dynamic measurements during the pivot-shift showed that the mean ATT was 7.2 ± 2.7 mm in the intact knee, 9.1 ± 3.3 mm in the ACL deficient knee(P = 0.04) and 9.7 ± 4.3 mm in the ACL 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) and 19.1° ± 3.1° in the ACL deficient knee with Segond’s lesion (P = 0.016). CONCLUSION: An isolated lesion of the ACL only affects ATT during static and dynamic measurements, while the addition of Segond’s fracture has a significant effect on ATR in both static and dynamic execution of the pivot-shift test, as evaluated with the aid of navigation.
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spelling pubmed-56859792017-11-28 Segond’s fracture: a biomechanical cadaveric study using navigation Monaco, E. Mazza, Daniele Redler, A. Lupariello, D. Lanzetti, R. Guzzini, M. Ferretti, A. J Orthop Traumatol Original Article BACKGROUND: Segond’s fracture is a well-recognised radiological sign of an anterior cruciate ligament (ACL) tear. While previous studies evaluated the role of the anterolateral ligament (ALL) and complex injuries on rotational stability of the knee, there are no studies on the biomechanical effect of Segond’s fracture in an ACL deficient knee. The aim of this study was to evaluate the effect of a Segond’s fracture on knee rotation stability as evaluated by a navigation system in an ACL deficient knee. MATERIALS AND METHODS: Three different conditions were tested on seven knee specimens: intact knee, ACL deficient knee and ACL deficient knee with Segond’s fracture. Static and dynamic measurements of anterior tibial translation (ATT) and axial tibial rotation (ATR) were recorded by the navigation system (2.2 OrthoPilot ACL navigation system B. Braun Aesculap, Tuttlingen, Germany). RESULTS: Static measurements at 30° showed that the mean ATT at 30° of knee flexion was 5.1 ± 2.7 mm in the ACL intact 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 was 20.7° ± 4.8° in the ACL intact condition, 26.9° ± 4.1° in the ACL deficient knee (P > 0.05) and 30.9° ± 3.8° after Segond’s fracture (P = 0.005). Dynamic measurements during the pivot-shift showed that the mean ATT was 7.2 ± 2.7 mm in the intact knee, 9.1 ± 3.3 mm in the ACL deficient knee(P = 0.04) and 9.7 ± 4.3 mm in the ACL 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) and 19.1° ± 3.1° in the ACL deficient knee with Segond’s lesion (P = 0.016). CONCLUSION: An isolated lesion of the ACL only affects ATT during static and dynamic measurements, while the addition of Segond’s fracture has a significant effect on ATR in both static and dynamic execution of the pivot-shift test, as evaluated with the aid of navigation. Springer International Publishing 2017-07-13 2017-12 /pmc/articles/PMC5685979/ /pubmed/28707122 http://dx.doi.org/10.1007/s10195-017-0460-0 Text en © The Author(s) 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Original Article
Monaco, E.
Mazza, Daniele
Redler, A.
Lupariello, D.
Lanzetti, R.
Guzzini, M.
Ferretti, A.
Segond’s fracture: a biomechanical cadaveric study using navigation
title Segond’s fracture: a biomechanical cadaveric study using navigation
title_full Segond’s fracture: a biomechanical cadaveric study using navigation
title_fullStr Segond’s fracture: a biomechanical cadaveric study using navigation
title_full_unstemmed Segond’s fracture: a biomechanical cadaveric study using navigation
title_short Segond’s fracture: a biomechanical cadaveric study using navigation
title_sort segond’s fracture: a biomechanical cadaveric study using navigation
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5685979/
https://www.ncbi.nlm.nih.gov/pubmed/28707122
http://dx.doi.org/10.1007/s10195-017-0460-0
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