A Tillaux fracture is a Salter–Harris type III

fracture Fracture is the separation of an object or material into two or more pieces under the action of stress. The fracture of a solid usually occurs due to the development of certain displacement discontinuity surfaces within the solid. If a displa ...

through the anterolateral aspect of the distal

tibia The tibia (; ), also known as the shinbone or shankbone, is the larger, stronger, and anterior (frontal) of the two bones in the leg below the knee in vertebrates (the other being the fibula, behind and to the outside of the tibia); it connects ...

l epiphysis. It occurs in older adolescents between the ages of 12 and 15 when the medial epiphysis had closed but before the lateral side has done so, due to an avulsion of the

anterior inferior tibiofibular ligament Standard anatomical terms of location are used to unambiguously describe the anatomy of animals, including humans. The terms, typically derived from Latin or Greek roots, describe something in its standard anatomical position. This position pro ...

, at the opposite end to a Wagstaffe-Le Fort avulsion fracture

Mechanism

Tillaux-Fraktur 11jw - CT cor sag ax - 001

The fracture commonly results from an abduction- external rotation force, causing the anterior tibiofibular ligament to avulse the anterolateral corner of the distal tibial epiphysis resulting in a Salter Harris Type III fracture.

Pathology

It occurs in older children at the end of growth. Variability in fracture pattern is due to progression of physeal closure as anterolateral part of distal tibial physis is the last to close. When the lateral physis is the only portion not fused, external rotation may lead to Tillaux or Triplane fractures.

Treatment

If the displacement at fracture is less than 2 mm, it may be managed conservatively. However, displacement requires

open reduction and internal fixation Internal fixation is an operation in orthopedics that involves the surgical implementation of implants for the purpose of repairing a bone, a concept that dates to the mid-nineteenth century and was made applicable for routine treatment in the m ...

, especially when displacement is over 2 mm.

Epidemiology

It occurs commonly in adolescents and older children. However, it does occur rarely in adults though it may be under reported because of difficulty in diagnosis.

Etymology

This fracture pattern is named after

Paul Jules Tillaux Paul Jules Tillaux (8 December 1834 – 20 October 1904) was a French physician who was a native of Aunay-sur-Odon, département Calvados. Tillaux was a surgeon and professor of surgery in Paris, and in 1879 became a member of the ''Académie de ...

, a French Anatomist and Surgeon (1834-1904).

References

External links

{{Fractures , state=collapsed Bone fractures Injuries of ankle and foot