Juvenile Tillaux Ankle Fracture
synonyms:
Juvenile Tillaux Fx ICD-9
Juvenile Tillaux Fx Etiology / Epidemiology / Natural History
- A Salter-Harris type II distal tibial fracture involving the anterolateral distal tibia.
- A form of transitional ankle fracture related to the asymmetric pattern of distal tibial physeal closure.
- Occur in early adolescence
- Thought to be caused by external rotation forces.
Juvenile Tillaux Fx Anatomy
- Fracture results from avulsion by the anterior tibiofibular ligament.
- Distal tibial growth plate closure starts anteromedially, progresses posteriorly and laterally and finishes anterolaterally.
Juvenile Tillaux Fx Clinical Evaluation
- Pain and deformity in the ankle, degree dependent on fracture severity.
- Evaluate skin integrity, swelling, and neurovascular status of the leg/foot.
Juvenile Tillaux Fx Xray / Diagnositc Tests
- A/P, lateral and mortise views of the ankle. Appears like a Tillaux fracture on A/P and mortise views.
- CT generally indicated. Demonstrates that fracture line does not extend through the anterior cortex. (Horn BD, JPO 2001;21:162).
- MRI generally not indicated although can provide information on ligamentous and physeal injury. (Lohman M, Skeletal Tadiol 2001;30:504).
Juvenile Tillaux Fx Classification / Treatment
- Nondisplaced: immobilization
- Displaced (>2mm): open or closed reduction and fixation with cannulated screws
Juvenile Tillaux Fx Associated Injuries / Differential Diagnosis
Juvenile Tillaux Fx Complications
- Delayed union, nonunion
- Malunion
- Growth arrest (uncommon)
- Arthritis
- Osteonecrosis of the distal tibial epiphysis
- Compartment syndrome
Juvenile Tillaux Fx Follow-up Care
Juvenile Tillaux Fx Review References
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