A renewed interest in anterior cruciate ligament preservation has been noted using arthroscopic primary repair in patients with proximal tears, but the main concern remained the control of the rotational instability. Segond fracture occurs in less than 10% of cases of acute anterolateral instability, but it can result in continued rotation instability. The aim of this study is to describe the surgical technique to acutely repair both the anterior cruciate ligament and Segond fracture in the acute setting.

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Aim. The aim of this study was to investigate whether the anatomical reconstruction on the radial tuberosity could be superior to the non-anatomical repair by tenodesis on brachialis, in terms of clinical outcomes and isokinetic evaluation to treat distal biceps brachii tendon ruptures. Methods. We retrospectively evaluated 36 patients at the final follow up; 16 were treated with the anatomical technique (Group A) and 20 with the non-anatomical (Group B). The isokinetic testing was used to assess the functional performance of both arms during flexion/extension and supination/pronation. We determined the Peak Torque, Total Work and Endurance. The clinical outcomes were evaluated using the main evaluation scales (DASH, Oxford Elbow score and MEPS). The Wilcoxon Two-Sample Test and the Chi-Square were used to evaluate the differences between the two groups for quantitative variables and qualitative variables, respectively. Results. According to clinical score, both treatments were considered satisfactory. The dynamometric tests demonstrated an overall superiority of the anatomical group compared to the non-anatomical group, with a statistical significant difference (p < 0.05) in the Peak Torque evaluated in flexion both at 90°/seconds and at 210°/seconds. The dominant arms achieved better results compared to the non-dominant extremities in all the tests. No major complications in any of the patients were reported. Conclusions. The anatomical technique using transosseous tunnels is a safe and effective procedure when used in acute patients. Although the non-anatomical treatment presented satisfactory results, the anatomical treatment is able to significantly reduce all the residual functional deficits usually present after the repair.