Tillaux fracture

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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

  • Ortho consult
  • 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

Disposition

  • Most will require surgical reduction
  • Admit

See Also

External Links

References