Citation, DOI, disclosures and article data
At the time the article was created Frank Gaillard had no recorded disclosures.View Frank Gaillard's current disclosures
At the time the article was last revised Sonam Vadera had no recorded disclosures.View Sonam Vadera's current disclosures
Tillaux fractures are Salter-Harris III fractures through the anterolateral aspect of the distal tibial epiphysis, with variable amounts of displacement.
On this page:
It occurs in older children and adolescents when the medial aspect of the distal tibial growth plate has started to fuse.
The fracture commonly results from an abduction-external rotation mechanism. With this mechanism, the anterior 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.
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 triplanar fracture.
Treatment and prognosis
The degree of displacement will dictate management. Operative reduction and internal fixation (ORIF) is required when the displacement is marked or unable to be corrected with closed reduction.
As with any intra-articular fracture, a persistent articular surface step predisposed the joint to premature secondary osteoarthritis.
History and etymology
It is named after Paul Jules Tillaux, French surgeon and anatomist (1834-1904) 2.
- 1. Protas JM, Kornblatt BA. Fractures of the lateral margin of the distal tibia. The Tillaux fracture. Radiology. 1981;138 (1): 55-7. Radiology (abstract) - Pubmed citation
- 2. Hunter TB, Peltier LF, Lund PJ. Radiologic history exhibit. Musculoskeletal eponyms: who are those guys? Radiographics. 20 (3): 819-36. Radiographics (full text) - Pubmed citation
- 3. Simon WH, Floros R, Schoenhaus H et-al. Juvenile fracture of tillaux. A distal tibial epiphyseal fracture. J Am Podiatr Med Assoc. 1989;79 (6): 295-9. doi:10.7547/87507315-79-6-295 - Pubmed citation