Tillaux fracture: Difference between revisions
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===Specific Management=== | ===Specific Management=== | ||
*Ortho consult | *Ortho consult | ||
==Disposition== | |||
*Most will require surgical reduction | |||
*Admit | |||
===Specialty Care=== | |||
*Nonoperative | *Nonoperative | ||
**closed reduction, long leg cast x 4wks, short leg cast x 2-3wks | **closed reduction, long leg cast x 4wks, short leg cast x 2-3wks | ||
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**Open reduction and internal fixation ('''OR'''IF) | **Open reduction and internal fixation ('''OR'''IF) | ||
**indicated if >2mm of displacement after reduction attempt | **indicated if >2mm of displacement after reduction attempt | ||
==See Also== | ==See Also== | ||
Latest revision as of 05:02, 18 September 2019
Background
- Salter-Harris type III fracture of the anterolateral portion of the distal tibia
- caused by an avulsion of anterior inferior tibiofibular ligament
- Occurs typically in adolescents, age 12-14
- occurs in children nearing skeletal maturity, as anterolateral portion most vulnerable at this age
Clinical Features
- Typically due to external rotation force
- forced lateral rotation of foot OR medial rotation of leg on a fixed foot
- Often associated with external rotation deformity of the ankle/foot
Differential Diagnosis
Distal Leg Fracture Types
- Tibial plateau fracture
- Tibial shaft fracture
- Pilon fracture
- Maisonneuve fracture
- Tibia fracture (peds)
- Ankle fracture
- Foot and toe fractures
Evaluation
- XR
- Salter-Harris III fracture of anterolateral distal tibia epiphysis
- CT scan
- further delineates fracture pattern and degree of displacement
Management
General Fracture Management
- Acute pain management
- Open fractures require immediate IV antibiotics and urgent surgical washout
- Neurovascular compromise from fracture requires emergent reduction and/or orthopedic intervention
- Consider risk for compartment syndrome
Specific Management
- Ortho consult
Disposition
- Most will require surgical reduction
- Admit
Specialty Care
- Nonoperative
- closed reduction, long leg cast x 4wks, short leg cast x 2-3wks
- indicated only if <2mm of displacement after closed reduction (rare)
- Operative
- Open reduction and internal fixation (ORIF)
- indicated if >2mm of displacement after reduction attempt
See Also
External Links
References
- Tintinalli 7th Edition, pg 905
- http://radiopaedia.org/articles/tillaux-fracture
- http://orthobullets.com/pediatrics/4028/tillaux-fractures