Avulsion Fracture of the Medial Tibial Plateau (reverse Segond Injury) Fabio Janson Angelini1, Eduardo Angeli Malavolta2, Caio Oliveira D ́elia3, José Ricardo Pécora4, Arnaldo Hernandez5, Gilberto

INTRODUCTION The Segond injury corresponds to a marginal avulsion fracture of lateral tibial plateau, resultant from flexion traumas, stress in varus and internal rotation. The structure responsible for avulsion is the lateral collateral ligament, and anterior cruciate ligament and lateral meniscal injuries are also frequently present(1-4). Hall and Hochman(5) provided the first report of an injury described as “Medial Segond-Type Fracture”, where clinical and imaging findings would be opposite to those of the classical Segond injury. They reported an avulsion fracture of the medial tibial plateau, caused by medial collateral ligament insertion (deep portion), combined to posterior cruciate ligament rupture and medial meniscal injury. Escobedo et al.(6) described three additional cases of this unusual injury, naming it as “Reverse-Segond Fracture”, these being the only reports in literature. In this article, we describe a case similar to the four previously published articles, where an avulsion fracture of the medial plateau was reported caused by deep medial collateral ligament and posterior cruciate ligament injury. This patient presented with concurrent anterior cruciate ligament injury, similarly to one of the cases previously described, and, differently from the others, it didn’t show meniscal injury. AVULSION FRACTURE OF THE MEDIAL TIBIAL PLATEAU (REVERSE SEGOND INJURY)