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Tillaux Fracture S82.209A 823.80

 

synonyms:

Juvenile Tillaux Fracture ICD-10

 

A- initial encounter for closed fracture

B- initial encounter for open fracture type I or II

C- initial encounter for open fracture type IIIA, IIIB, or IIIC

D- subsequent encounter for closed fracture with routine healing

E- subsequent encounter for open fracture type I or II with routine healing

F- subsequent encounter for open fracture type IIIA, IIIB, or IIIC with routine healing

G- subsequent encounter for closed fracture with delayed healing

H- subsequent encounter for open fracture type I or II with delayed healing

J- subsequent encounter for open fracture type IIIA, IIIB, or IIIC with delayed healing

K- subsequent encounter for closed fracture with nonunion

M- subsequent encounter for open fracture type I or II with nonunion

N- subsequent encounter for open fracture type IIIA, IIIB, or IIIC with nonunion

P- subsequent encounter for closed fracture with malunion

Q- subsequent encounter for open fracture type I or II with malunion

R- subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion

S- sequela

Juvenile Tillaux Fracture ICD-9

  • 823.80(closed fracture of unspecified part of tibia)

Juvenile Tillaux Fracture 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 Fracture 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 Fracture 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 Fracture 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 Fracture Classification / Treatment

  • Nondisplaced: immobilization
  • Displaced (>2mm): open or closed reduction and fixation with cannulated screws

Juvenile Tillaux Fracture Associated Injuries / Differential Diagnosis

  • Pediatric Distal Tibial Fracture
  • Triplane Ankle Fracture
  • Adolescent Pilon Fracture
  • Incisural Ankle Fracture

Juvenile Tillaux Fracture Complications

  • Delayed union, nonunion
  • Malunion
  • Growth arrest (uncommon)
  • Arthritis
  • Osteonecrosis of the distal tibial epiphysis
  • Compartment syndrome

Juvenile Tillaux Fracture Follow-up Care

Juvenile Tillaux Fracture Review References

Rockwood and Wilkin's Fractures in Children 6th ed, 2006

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