Tillaux fracture
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Updates to Article Attributes
Tillaux fractures are Salter-Harris III fractures through the anterolateral aspect of the distal tibial epiphysis, with variable amounts of displacement.
Epidemiology
It occurs in older children and adolescents when the medial aspect of the distal tibial growth plate has started to fuse.
Pathology
The fracture commonly results from an abduction-external rotation mechanism. With this mechanism, the inferior anteroinferior tibiofibular ligament avulses the anterolateral corner of the distal tibial epiphysis 3.
The fracture requires an open physis (the lateral aspect of the distal tibial physis usually closes between 12 to 15 years of age while the medial aspect closes earlier). The lateral epiphyseal involvement is due to growth plate fusion commencing from medial to lateral aspect.
Radiographic features
Vertical fracture through the distal tibial epiphysis (Salter-Harris III) with a horizontal extension through the lateral aspect of the physis. The lack of aNo metaphyseal fracture component in the coronal plane (evaluated with lateral x-ray or CT) distinguishes a Tillaux fracture from a triplane fracture
Treatment and prognosis
The degree of displacement will dictate management. Open reduction and internal fixation (ORIF) is required when the displacement is marked or cannot be corrected with closed reduction.
Complications
As with any intra-articular fracture, a persistent articular surface step predisposes the joint to premature secondary osteoarthritis.
History and etymology
ItThis fracture pattern is named after Paul Jules Tillaux, French surgeon and anatomist (1834-1904) 2.
Differential diagnosis
triplane fracture: has a metaphyseal fracture
-<p><strong>Tillaux fractures</strong> are <a href="/articles/salter-harris-classification">Salter-Harris III</a> fractures through the anterolateral aspect of the distal tibial epiphysis, with variable amounts of displacement.</p><h4>Epidemiology</h4><p>It occurs in older children and adolescents when the medial aspect of the distal tibial growth plate has started to fuse.</p><h4>Pathology</h4><p>The fracture commonly results from an abduction-external rotation mechanism. With this mechanism, the inferior anteroinferior tibiofibular ligament avulses the anterolateral corner of the distal tibial epiphysis <sup>3</sup>.</p><p>The fracture requires an open physis (the lateral aspect of the distal tibial physis usually closes between 12 to 15 years of age while the medial aspect closes earlier). The lateral epiphyseal involvement is due to growth plate fusion commencing from medial to lateral aspect.</p><h4>Radiographic features</h4><p>Vertical fracture through the distal tibial epiphysis (Salter-Harris III) with a horizontal extension through the lateral aspect of the physis. The lack of a metaphyseal fracture component in the coronal plane (evaluated with lateral x-ray or CT) distinguishes a Tillaux fracture from a <a href="/articles/triplanar-fracture">triplane fracture</a>.</p><h4>Treatment and prognosis</h4><p>The degree of displacement will dictate management. <a href="/articles/orif">Open reduction and internal fixation</a> (ORIF) is required when the displacement is marked or cannot be corrected with <a href="/articles/closed-reduction">closed reduction</a>.</p><h5>Complications</h5><p>As with any <a href="/articles/intra-articular-fracture">intra-articular fracture</a>, a persistent articular surface step predisposes the joint to premature <a href="/articles/post-traumatic-osteoarthritis" title="Post-traumatic osteoarthritis">secondary osteoarthritis</a>.</p><h4>History and etymology</h4><p>It is named after <strong>Paul Jules Tillaux</strong>, French surgeon and anatomist (1834-1904) <sup>2</sup>.</p>- +<p><strong>Tillaux fractures</strong> are <a href="/articles/salter-harris-classification">Salter-Harris III</a> fractures through the anterolateral aspect of the distal tibial epiphysis, with variable amounts of displacement.</p><h4>Epidemiology</h4><p>It occurs in older children and adolescents when the medial aspect of the distal tibial growth plate has started to fuse.</p><h4>Pathology</h4><p>The fracture commonly results from an abduction-external rotation mechanism. With this mechanism, the inferior anteroinferior tibiofibular ligament avulses the anterolateral corner of the distal tibial epiphysis <sup>3</sup>.</p><p>The fracture requires an open physis (the lateral aspect of the distal tibial physis usually closes between 12 to 15 years of age while the medial aspect closes earlier). The lateral epiphyseal involvement is due to growth plate fusion commencing from medial to lateral aspect.</p><h4>Radiographic features</h4><p>Vertical fracture through the distal tibial epiphysis (Salter-Harris III) with a horizontal extension through the lateral aspect of the physis. No metaphyseal fracture is present.</p><h4>Treatment and prognosis</h4><p>The degree of displacement will dictate management. <a href="/articles/orif">Open reduction and internal fixation</a> (ORIF) is required when the displacement is marked or cannot be corrected with <a href="/articles/closed-reduction">closed reduction</a>.</p><h5>Complications</h5><p>As with any <a href="/articles/intra-articular-fracture">intra-articular fracture</a>, a persistent articular surface step predisposes the joint to premature <a href="/articles/post-traumatic-osteoarthritis" title="Post-traumatic osteoarthritis">secondary osteoarthritis</a>.</p><h4>History and etymology</h4><p>This fracture pattern is named after <strong>Paul Jules Tillaux</strong>, French surgeon and anatomist (1834-1904) <sup>2</sup>.</p><h4>Differential diagnosis</h4><ul><li><p><a href="/articles/triplane-fracture" title="Triplane fracture">triplane fracture</a>: has a metaphyseal fracture</p></li></ul>
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