Tillaux fracture: Difference between revisions
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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 | ||
| Line 15: | Line 15: | ||
==Evaluation== | ==Evaluation== | ||
*XR | *XR | ||
**Salter-Harris III | **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 ( | **Open reduction and internal fixation ('''OR'''IF) | ||
**indicated if >2mm of displacement after reduction attempt | **indicated if >2mm of displacement after reduction attempt | ||
==See Also== | ==See Also== | ||
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<references/> | <references/> | ||
[[Category: Orthopedics | [[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 Fracture Types
- Tibial plateau fracture
- Tibial shaft fracture
- Pilon fracture
- Maisonneuve fracture
- Tibia fracture (peds)
- Ankle fracture
- Foot and toe 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
- Acute pain management
- Open fractures require immediate IV antibiotics and urgent surgical washout
- Neurovascular compromise from fracture requires emergent reduction and/or orthopedic intervention
- Consider risk for compartment syndrome
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
- Tintinalli 7th Edition, pg 905
- http://radiopaedia.org/articles/tillaux-fracture
- http://orthobullets.com/pediatrics/4028/tillaux-fractures