Difference between revisions of "Tillaux fracture"

(Created page with "==Background== *Salter-Harris type III fracture of the anterolateral portion of the distal tibia **caused by an avulsion of anterior inferior tibiofibular ligament *Occurs typ...")
 
 
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==Clinical Features==
 
==Clinical Features==
 
*Typically due to external rotation force
 
*Typically due to external rotation force
**forced lateral rotation of foot OR medial rotation of leg on a fixed foot
+
**forced lateral rotation of foot '''OR''' medial rotation of leg on a fixed foot
 
*Often associated with external rotation deformity of the ankle/foot
 
*Often associated with external rotation deformity of the ankle/foot
  
 
==Differential Diagnosis==
 
==Differential Diagnosis==
'''Distal Leg Fractures'''
+
{{Distal leg fractures DDX}}
*[[Tibial shaft fracture]]
 
*[[Pilon fracture]]
 
*[[Maisonneuve fracture]]
 
*[[Tibia fracture (peds)]]
 
*[[Ankle fracture]]
 
**[[Ankle fracture (peds)]]
 
*[[Foot and toe fractures]]
 
*Triplane fracture
 
 
 
'''Ankle Injuries'''
 
*[[Ankle sprain]]
 
*[[Ankle dislocation]]
 
  
 
==Evaluation==
 
==Evaluation==
 
*XR
 
*XR
**Salter-Harris III fx of anterolateral distal tibia epiphysis
+
**Salter-Harris III fracture of anterolateral distal tibia epiphysis
 
*CT scan
 
*CT scan
 
**further delineates fracture pattern and degree of displacement
 
**further delineates fracture pattern and degree of displacement
  
 
==Management==
 
==Management==
 +
{{General Fracture Management}}
 +
 +
===Specific Management===
 
*Ortho consult
 
*Ortho consult
 +
 +
==Disposition==
 +
*Most will require surgical reduction
 +
*Admit
 +
 +
===Specialty Care===
 
*Nonoperative
 
*Nonoperative
 
**closed reduction, long leg cast x 4wks, short leg cast x 2-3wks
 
**closed reduction, long leg cast x 4wks, short leg cast x 2-3wks
 
**indicated only if <2mm of displacement after closed reduction (rare)
 
**indicated only if <2mm of displacement after closed reduction (rare)
 
*Operative
 
*Operative
**Open reduction and internal fixation (ORIF)
+
**Open reduction and internal fixation ('''OR'''IF)
 
**indicated if >2mm of displacement after reduction attempt
 
**indicated if >2mm of displacement after reduction attempt
 
==Disposition==
 
*Most will require surgical reduction
 
*Admit
 
  
 
==See Also==
 
==See Also==
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<references/>
 
<references/>
  
[[Category: Orthopedics, Pediatrics]]
+
[[Category: Orthopedics]]
 +
[[Category: Pediatrics]]

Latest revision as of 05:02, 18 September 2019

Background

  • Salter-Harris type III fracture of the anterolateral portion of the distal tibia
    • caused by an avulsion of anterior inferior tibiofibular ligament
  • Occurs typically in adolescents, age 12-14
    • occurs in children nearing skeletal maturity, as anterolateral portion most vulnerable at this age

Clinical Features

  • Typically due to external rotation force
    • forced lateral rotation of foot OR medial rotation of leg on a fixed foot
  • Often associated with external rotation deformity of the ankle/foot

Differential Diagnosis

Distal Leg Fractures

Evaluation

  • XR
    • Salter-Harris III fracture of anterolateral distal tibia epiphysis
  • CT scan
    • further delineates fracture pattern and degree of displacement

Management

General Fracture Management

Specific Management

  • Ortho consult

Disposition

  • Most will require surgical reduction
  • Admit

Specialty Care

  • Nonoperative
    • closed reduction, long leg cast x 4wks, short leg cast x 2-3wks
    • indicated only if <2mm of displacement after closed reduction (rare)
  • Operative
    • Open reduction and internal fixation (ORIF)
    • indicated if >2mm of displacement after reduction attempt

See Also

External Links

References