Adolescent Tillaux Fractures: A Systematic Review of the Literature (original) (raw)
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Displaced juvenile Tillaux fractures
Wiener klinische Wochenschrift, 2016
Background Approximately 15 % of all juvenile injuries of the long bones involve the epiphyseal growth plate, and 2.9 % of these are juvenile Tillaux fractures. The Tillaux fracture is of great importance because it involves a major weight-bearing articular surface. Treatment protocols in the literature are not uniform for this kind of fracture, and numerous case reports can be found describing various treatment methods. The aim of this study was to present the clinical outcome at long-term follow-up after treatment of displaced Tillaux fractures. Methods In all, 168 children and adolescent patients with physeal injuries of the distal tibia were treated
Journal of Orthopaedic Case Reports, 2018
Introduction: The Tillaux fracture is a rare subtype of tibial physeal fracture that usually occurs in adolescents. There are only a few case series or reports published in the literature and, to our knowledge, this is the first time, a painful nonunion is reported after this type of fracture. Case Report: A 13-year-old athlete presented to our orthopedic department because of persistent pain after an acute ankle injury 2months before. She was diagnosed with a Tillaux fracture that eventually progressed to nonunion after conservative treatment. Surgery was performed to treat the nonunion, and the fracture fragment was fixed using a soft suture anchor. Conclusion: The Tillaux fracture pattern requires a high level of clinical suspicion and careful evaluation since it can be misdiagnosed as a simple ankle sprain in adolescents and progress to persistent ankle pain without appropriate treatment. Our surgical technique of suture anchor fixation avoids the risk of fragmentation of the fr...
Treatment for displaced Tillaux fractures in adolescent age group
Foot and Ankle Surgery, 2020
Limitations of the study: Although our series is one of the largest series of the literature and one of the series with longest follow-up, we believe that a larger series with longer follow-up and with control groups are necessary for more strict conclusions. Conclusion: Our study shows that anatomically reduced Tillaux fractures at adolescent age group either by closed or opened means, followed by postoperative plaster cast immobilization will lead to excellent results.
Oblique Compression Screw Fixation across the Physis for Tillaux Fractures in Adolescent
Objective: Tillaux fractures are uncommon physeal injuries sustained by adolescents. Two different fixation techniques are described; the first involves placement of a screw obliquely into the tibial metaphysis, while the second involves placement of a screw parallel through the epiphysis without violating the physis. The purpose of this study was to report the outcomes, complications, and advantages of oblique screw fixation.
Journal of pediatric orthopedics. Part B, 2018
The goal of this study was to compare open reduction versus percutaneous fixation of adolescent ankle fractures with regards to the incidence of growth disturbance. We performed a retrospective cohort analysis of adolescent patients with triplane or Tillaux fractures. There was an even distribution of triplane fractures and mean initial displacement between cohorts. Analysis of follow-up radiographs revealed no instances of growth disturbance in the percutaneous fixation group and six in the open reduction group (P=0.29). Growth disturbance does not pose a significant concern when selecting a surgical approach. Owing to the rarity of these fractures this study was underpowered.
Orthopaedic Surgery and Traumatology Case Report The Tillaux Fracture in Adult
2017
We describe a bimalleolar fracture of the right ankle in a 24 year old man with an associated ankle subluxation and fracture of the anterolateral aspect of distal tibia-the adult tillaux fracture. Adult tillaux fracture is an extremely rare fracture pattern with very few cases reported in the literature. The case described is of a 24 year old male who sustained the injury while trekking in the hills. Careful evaluation of x rays AP, lateral and oblique views are helpful in identifying the tillaux fracture. We would also recommend evaluation with CT. The case was seen in emergency 12 hours after the fall. He presented with a swollen ankle and foot. Skin overlying the medial mal-leolus had abrasions and gross ecchymosis. Distal neurovascular status was intact. X rays showed fracture of the lower fibula, medial mal-leolar fracture with separation of the malleolus, subluxation of talus with disruption of the ankle joint and fracture of the antero lateral aspect of distal tibia. The pati...
Asisstance Arthroscopy in Juvenile Tillaux Fractures
Orthopaedic Journal of Sports Medicine, 2017
Introduction: Juvenile Tillaux Fracture is an isolated fracture of the lateral portion of the distal tibial epiphysis, considered SALTER-HARRIS fracture type 3, wherein the fragment is moved by the anterolateral ligament anterior inferior tibiofibular. They occur at the beginning of the 2nd decade of life and are caused by a force external rotation. The pattern of injury is considered a result of the closing sequence of the distal tibial physis, which usually closes around 15 years of age in girls and 17 in boys, this process usually takes about 18 months, occurring first in the central area of the physis, extending medially and finally to side, being this epiphyseal portion which is open at the time of the vulnerable to fracture injury in this age group. The curriculum includes RX, and TAC, being more sensitive to detect fragments of 2 or more mm of travel, but may overestimate the true displacement. The non-displaced fracture can be treated with cast immobilization and displaced w...
Isolated Adult Tillaux Fracture Associated With Volkmann Fracture: A Unique Combination of Injuries
Avulsion fractures of the anterior inferior tibiofibular ligament from its tibial attachment, Tillaux fractures, are usually seen in adolescents during the interval of the distal tibial epiphyseal closure. However, this pattern of fracture is rare in adult patients, because the ligaments will usually fail before the bone fails. Avulsion fracture of the posterior inferior tibiofibular ligament from its tibial attachment, Volkmann fracture, is the posterolateral counterpart of a similar injury. In the present study, the cases of 2 adult patients with simultaneous Tillaux and Volkmann fractures are reported and the mechanism of injury, diagnosis, and treatment discussed. This fracture pattern is extremely rare and, to the best of our knowledge, has not been previously reported.
The Duke Orthopaedic Journal, 2016
The juvenile Tillaux fracture is a transitional ankle fracture that occurs in the adolescent population. The juvenile Tillaux fracture is an avulsion injury of the distal tibia's anterolateral epiphysis as the result of excessive external rotation. The purpose of this article is to present a pediatric ankle fracture that is best described as a supination-external rotation type IV ankle injury with an associated Tillaux fragment. This fracture pattern represents a unique variant to classically described pediatric ankle fractures. Dial BL, Morwood MP, Fitch RD. Pediatric Tillaux Ankle Fracture with Concomitant Adult-type Supination External Rotation Fracture Pattern: A Rare Injury. The Duke Orthop J 2016;6(1):61-63.