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Tillaux fracture

Case contributed by Yaïr Glick
Diagnosis certain

Presentation

Pain in right foot.

Patient Data

Age: 15 years
Gender: Male
x-ray

Tillaux fracture, i.e. Salter-Harris III fracture of anterolateral aspect of distal tibial epiphysis, minimally displaced.

ct

CT performed to rule out occult fractures, i.e. fractures other than the Tillaux fracture seen on the radiographs. None demonstrated.
The soft tissue window (not shown) reveals the anterior tibiofibular ligament attached to the epiphyseal fragment.

x-ray

Radiographs taken right after cast removal. A cannulated screw was used for internal fixation.

Case Discussion

Patient presented with "pain in right foot" after having landed hard on it during playing.
On physical examination, there was swelling at the distal tibial-fibular border; tenderness to palpation across the swelling; antalgic restriction of movement, particularly on external rotation of ankle.

Radiographs showed a minimally displaced Salter-Harris type III fracture of the distal tibia, also known as a Tillaux fracture, at the anterolateral aspect.

CT did not demonstrate any additional fracture.

Closed reduction was performed, then a 4.5 mm cannulated screw was used for internal fixation.

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