Abstract
SummaryBackgroundApproximately 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.MethodsIn all, 168 children and adolescent patients with physeal injuries of the distal tibia were treated from 2003 to 2012. Seven patients were identified as having Tillaux fractures requiring surgical treatment and therefore were included in our study and evaluated retrospectively.ResultsSeven patients with Tillaux fractures underwent surgical reconstruction by open or closed reduction. Excellent results were achieved in 90 % of the patients, with a mean Foot and Ankle Score at the last follow-up of 98.71.ConclusionAnatomical reduction is required for every displaced epiphyseal fracture via open reduction and internal fixation, especially in cases with ≥2 mm fragment displacement. Plaster cast immobilization and non-weight-bearing mobilization for at least 4 weeks might be a good way of ensuring optimal surgical results and preventing complications.
Highlights
An isolated fracture of the anterolateral distal tibial epiphysis is called juvenile Tillaux fracture
Anatomical reduction is required for every displaced epiphyseal fracture via open reduction and internal fixation, especially in cases with ≥2 mm fragment displacement
15 % of all juvenile injuries of the long bones involve the epiphyseal growth plate [2], fractures of the distal tibial epiphysis account for 11–20 % to these injuries [3], and 2.9 % of these are juvenile Tillaux fractures [4]
Summary
An isolated fracture of the anterolateral distal tibial epiphysis is called juvenile Tillaux fracture. Paul Jules Tillaux first described the avulsion fracture of the distal tibial physis in 1892 [1]. 15 % of all juvenile injuries of the long bones involve the epiphyseal growth plate [2], fractures of the distal tibial epiphysis account for 11–20 % to these injuries [3], and 2.9 % of these are juvenile Tillaux fractures [4]. Triplane and Tillaux fractures occur after supination external rotation and compression stress with unpredictable multiplanar fracture patterns [5]. The open region represents an area of weakness in the distal tibia with a risk for Tillaux fractures [6]. Because the fracture can appear different on X-ray images, computed tomography is often necessary to deter-
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