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Tillaux fracture

Case contributed by Yasser Asiri

Presentation

Trauma with severe pain and ankle swelling.

Patient Data

Age: 15 years
Gender: Female
x-ray

Vertically oriented fracture line through the lateral aspect of the distal tibial epiphysis extending horizontally into the growth plate.

ct

CT imaging confirms the morphology of the fracture as a vertical fracture begins anterolaterally within the epiphysis and extends horizontally through the unclosed growth plate, the imaging finding is consistent with Tillaux fracture. Minimal lateral displacement of the lateral aspect of the distal tibial epiphysis, however, no significant rotation. Notice the partial closure of the physis medially. 

Case Discussion

This case shows the typical appearance of Tillaux fracture. It is a Salter-harris type III fracture commonly seen in adolescents where the medial aspect of the distal tibial physis is closed but the lateral aspect remains open.  CT study is helpful to assess the displacement of the tibial fracture fragment and articular surface congruity.

The absence of metaphyseal involvement helps to differentiate between Tillaux and triplane fractures. 

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