title: The double flipped meniscus sign: unusual MRI findings in bucket-handle tear of the lateral meniscus.
abstract: Bucket-handle meniscal tears are either longitudinal, vertical, or oblique in direction with an attached tear fragment displaced from the meniscus. Magnetic resonance imaging (MRI) signs are widely used in the diagnosis of these tears, including the 'fragment within the intercondylar notch sign', 'flipped meniscus sign', 'double anterior horn sign', 'absence of the bow tie sign', 'double posterior cruciate ligament (PCL) sign', 'posterior double PCL sign', and 'triple PCL sign'. We report an unusual case, not yet described in previous studies, of a bucket-handle tear presenting as a double longitudinal tear of the lateral meniscus (LM). Two longitudinal tears were observed in the white-white zone and the red-white zone of the LM, where both fragments were shown to be displaced and locked within the intercondylar notch. Partial menisectomy was performed for the central fragment and a repair with modified all-inside sutures was performed for the peripheral fragment.
authors.affiliation: Department of Orthopaedic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul 110-746, South Korea. Electronic address: jha3535@naver.com.
authors.forename: Jin Hwan
authors.initials: JH
authors.lastname: Ahn
authors.affiliation: Department of Orthopedic Surgery, Soonchunhyang University School of Medicine, 1174 Jung-dong, Wonmi-gu, Bucheon 420-767, South Korea. Electronic address: yimsj@schmc.ac.kr.
authors.forename: Soo Jae
authors.initials: SJ
authors.lastname: Yim
authors.affiliation: Department of Orthopedic Surgery, Soonchunhyang University School of Medicine, 1174 Jung-dong, Wonmi-gu, Bucheon 420-767, South Korea. Electronic address: ciel0427@hanmail.net.
authors.forename: Yu Seok
authors.initials: YS
authors.lastname: Seo
authors.affiliation: Department of Orthopedic Surgery, Soonchunhyang University School of Medicine, 1174 Jung-dong, Wonmi-gu, Bucheon 420-767, South Korea. Electronic address: colorko@naver.com.
authors.forename: Taeg Su
authors.initials: TS
authors.lastname: Ko
authors.affiliation: Department of Orthopaedic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul 110-746, South Korea. Electronic address: ljhkbsmc@naver.com.
authors.forename: Joon Hee
authors.initials: JH
authors.lastname: Lee
mesh_terms: D001182:Arthroscopy; D006801:Humans; D007719:Knee Joint / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008592:Menisci, Tibial / Q000473:pathology* / Q000601:surgery; D012916:Soccer / Q000293:injuries; D013536:Suture Techniques; D000070600:Tibial Meniscus Injuries; D055815:Young Adult
keywords: Double bucket-handle tear; Double flipped meniscus sign; Lateral meniscus