Tillaux fracture: Difference between revisions
(Text replacement - "OR" to "'''OR'''") |
|||
| Line 7: | Line 7: | ||
==Clinical Features== | ==Clinical Features== | ||
*Typically due to external rotation force | *Typically due to external rotation force | ||
**forced lateral rotation of foot OR medial rotation of leg on a fixed foot | **forced lateral rotation of foot '''OR''' medial rotation of leg on a fixed foot | ||
*Often associated with external rotation deformity of the ankle/foot | *Often associated with external rotation deformity of the ankle/foot | ||
| Line 25: | Line 25: | ||
**indicated only if <2mm of displacement after closed reduction (rare) | **indicated only if <2mm of displacement after closed reduction (rare) | ||
*Operative | *Operative | ||
**Open reduction and internal fixation ( | **Open reduction and internal fixation ('''OR'''IF) | ||
**indicated if >2mm of displacement after reduction attempt | **indicated if >2mm of displacement after reduction attempt | ||
Revision as of 22:28, 30 May 2017
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 fx of anterolateral distal tibia epiphysis
- CT scan
- further delineates fracture pattern and degree of displacement
Management
- Ortho consult
- 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
Disposition
- Most will require surgical reduction
- Admit
See Also
External Links
References
- Tintinalli 7th Edition, pg 905
- http://radiopaedia.org/articles/tillaux-fracture
- http://orthobullets.com/pediatrics/4028/tillaux-fractures