S Pannier1, T Odent, A Milet, R Vialle, C Glorion. 1. Service Orthopédie et Traumatologie Pédiatriques, Hôpital des Enfants-Malades. 149, rue de Sèvres, 75015 Paris.
Abstract
PURPOSE OF THE STUDY: Tillaux fractures in adolescents correspond to Salter and Harris type III fractures involving the anterolateral portion of the tibial epiphysis. These are intra-articular fractures. The objective was to determine the circumstances of these fractures, the radiological signs, and the therapeutic modalities as well as the long-term clinical and radiological outcome. MATERIAL AND METHODS: We reviewed 19 Tillaux fractures. Ten patients underwent surgical treatment and nine orthopedic treatment following importance of displacement. RESULTS: At mean follow-up of 33.8 months, results were rated good in 17 on 19 cases. DISCUSSION: This fracture is often observed in teenagers victims of trauma with external rotation of the foot. Closure of distal growth cartilage of the tibia occurs medially to laterally, the anterolateral portion remaining open longer. Forced external rotation of the anterior tibiofibular ligament pulls off an anterolateral fragment of the distal tibial epiphysis. Surgical treatment is indicated for fractures with a displacement of more than 2 mm or a vertical displacement to achieve open reduction and screw fixation. Orthopedic treatment is used for non-displaced fractures. CONCLUSION: The prognosis of Tillaux fractures is good as was observed in our series and in series reported in the literature.
PURPOSE OF THE STUDY: Tillaux fractures in adolescents correspond to Salter and Harris type III fractures involving the anterolateral portion of the tibial epiphysis. These are intra-articular fractures. The objective was to determine the circumstances of these fractures, the radiological signs, and the therapeutic modalities as well as the long-term clinical and radiological outcome. MATERIAL AND METHODS: We reviewed 19 Tillaux fractures. Ten patients underwent surgical treatment and nine orthopedic treatment following importance of displacement. RESULTS: At mean follow-up of 33.8 months, results were rated good in 17 on 19 cases. DISCUSSION: This fracture is often observed in teenagers victims of trauma with external rotation of the foot. Closure of distal growth cartilage of the tibia occurs medially to laterally, the anterolateral portion remaining open longer. Forced external rotation of the anterior tibiofibular ligament pulls off an anterolateral fragment of the distal tibial epiphysis. Surgical treatment is indicated for fractures with a displacement of more than 2 mm or a vertical displacement to achieve open reduction and screw fixation. Orthopedic treatment is used for non-displaced fractures. CONCLUSION: The prognosis of Tillaux fractures is good as was observed in our series and in series reported in the literature.