Displaced juvenile Tillaux fractures : Surgical treatment and outcome

Wien Klin Wochenschr. 2017 Mar;129(5-6):169-175. doi: 10.1007/s00508-016-1059-9. Epub 2016 Aug 17.

Abstract

Background: Approximately 15 % of all juvenile injuries of the long bones involve the epiphyseal growth plate, and 2.9 % of these are juvenile Tillaux fractures. The Tillaux fracture is of great importance because it involves a major weight-bearing articular surface. Treatment protocols in the literature are not uniform for this kind of fracture, and numerous case reports can be found describing various treatment methods. The aim of this study was to present the clinical outcome at long-term follow-up after treatment of displaced Tillaux fractures.

Methods: In all, 168 children and adolescent patients with physeal injuries of the distal tibia were treated from 2003 to 2012. Seven patients were identified as having Tillaux fractures requiring surgical treatment and therefore were included in our study and evaluated retrospectively.

Results: Seven patients with Tillaux fractures underwent surgical reconstruction by open or closed reduction. Excellent results were achieved in 90 % of the patients, with a mean Foot and Ankle Score at the last follow-up of 98.71.

Conclusion: Anatomical reduction is required for every displaced epiphyseal fracture via open reduction and internal fixation, especially in cases with ≥2 mm fragment displacement. Plaster cast immobilization and non-weight-bearing mobilization for at least 4 weeks might be a good way of ensuring optimal surgical results and preventing complications.

Keywords: Foot and ankle score; Open reduction; Operative treatment; Retrospective study; Tillaux fracture.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Ankle Fractures / diagnosis
  • Ankle Fractures / rehabilitation
  • Ankle Fractures / surgery*
  • Combined Modality Therapy / methods
  • Female
  • Fracture Fixation / methods*
  • Fracture Fixation / rehabilitation
  • Fracture Healing
  • Fractures, Malunited / diagnosis
  • Fractures, Malunited / rehabilitation
  • Fractures, Malunited / surgery*
  • Humans
  • Immobilization
  • Male
  • Plastic Surgery Procedures / methods*
  • Plastic Surgery Procedures / rehabilitation
  • Prevalence
  • Recovery of Function
  • Risk Factors
  • Tibial Fractures / diagnosis
  • Tibial Fractures / rehabilitation
  • Tibial Fractures / surgery*
  • Treatment Outcome