Segond Fractures Are Not a Risk Factor for Anterior Cruciate Ligament Reconstruction Failure: Letter to the Editor

Editorial Commentary: The Segond Fracture Has Multiple Attachments: Yet Another Demonstration of the Anatomical Complexity of the Anterolateral Complex of the Knee

The anterolateral complex (ALC) of the knee comprises multiple layers, with continued debate on the identity and function of the structures of the ALC. The Segond fracture, long considered pathognomonic of an anterior cruciate ligament injury, has now been shown to have several attachments to soft tissues of the ALC. To the extent that a Segond fracture, or injury to the ALC more broadly, increases knee rotatory instability in vivo is a question of ongoing investigation. By extension, it remains uncertain whether an untreated Segond fracture adversely affects outcomes and therefore warrants consideration for operative intervention. Prospective randomized studies of anatomic anterior cruciate ligament reconstruction with or without concomitant treatment of Segond fractures are needed to more definitively answer these questions.

Editorial Commentary: Knee Anterolateral Ligament Bashing-Why So Much Negativity?

Articles on the anterolateral ligament have generated lots of discussion, but a worldwide consensus has been recently reached: the anterolateral ligament exists. Cadaver studies on a small number of subjects should not be used to draw conclusions as they do not replicate real life. We place our faith in clinical studies with a large number of patients as they capture the variability encountered in our practices. This is the true test of a scientific concept.