Forced external rotation of the foot may cause a syndesmosis or high ankle sprain in an adult, but in a teenage patient, a juvenile Tillaux fracture may occur if the tibial physis has not yet closed. Diagnosis is made with plain radiographs, but CT may be necessary to determine the true articular displacement. Closed reduction with casting for 6 weeks is usually sufficient for most nondisplaced or minimally displaced fractures. Patients with more than 2 mm of displacement, as in this case of a 16-year-old basketball player, should be referred to an orthopedic surgeon. Complications include residual angular deformity and premature osteoarthritis. Most patients are able to return to full activity at 3 months postinjury.
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Closed reduction and internal fixation for tillaux fractures, based on pre-operative three-dimensional computed tomography.
Eur J Orthop Surg Traumatol
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Department of Orthopaedic Surgery, Ajou University Medical School of Medicine, 164, World Cup-Ro, Yeongtong-Gu, Suwon-Si, Gyeonggi-Do, Suwon, Republic of Korea.
Objective: This study aimed to propose treatment protocol and identify patterns of tillaux fractures using three-dimensional (3D) computed tomography (CT) analysis and to describe an effective reduction technique.
Methods: Forty-two juvenile patients with tillaux fractures were evaluated with 3D-CT scan for fracture displacement pattern and received surgical treatment. Tillaux fragment was reduced by pushing the superomedial quadrant part of the fragment slightly downward towards the ankle joint from anterolateral to posteromedial through 5-mm skin incisions with mosquito forceps.
Adolescent Tillaux Fractures: A Systematic Review of the Literature.
Cureus
January 2021
Trauma and Orthopaedics, Hull University Teaching Hospitals NHS Trust, Hull, GBR.
The Tillaux fracture is an uncommon injury to the anterolateral distal tibial epiphysis. It occurs during a distinct time period when adolescent patients are transitioning to skeletal maturity. Owing to its rarity, the optimal management strategy for this fracture is not well-described.
View Article and Find Full Text PDFBelow-Knee Cast Immobilization for Distal Tibial Physeal Fractures.
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Orthopaedic Surgeon, Department of Orthopaedic Surgery, Naval Medical Center Camp Lejeune, Camp Lejeune, NC.
Distal tibial physeal injuries are one of the most commonly reported fractures in children. Traditionally, treatment recommendations consist of utilization of a long leg cast for initial immobilization. The purpose of this study was to evaluate the efficacy of below-knee cast immobilization in the closed treatment of distal tibial physeal fractures.
View Article and Find Full Text PDFTreatment for displaced Tillaux fractures in adolescent age group.
Foot Ankle Surg
April 2020
Orthopedics and Traumatology Department, Tanta Faculty of Medicine, Tanta University, Egypt. Electronic address:
Background: Around age 11-15 years, a forced external rotation of the foot in a supination or a medial rotation of the leg on the fixed foot usually is responsible for an avulsion injury to the anterolateral epiphysis, known as Tillaux fracture. Ligamentous injuries are rare in children because ligaments are stronger than is the growth plate that frequently is injured.
Objective: The aim of this study was to present the clinical outcome until the end of growth after surgical treatment for displaced adolescent Tillaux fractures.
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