Mohamed Ebrahim Ali Al-Ashhab1, Ashraf Atef Mahmoud Mohamed2. 1. Orthopedics and Traumatology Department, Benha Faculty of Medicine, Benha University, Egypt. Electronic address: mohamed.alsayed03@fmed.bu.edu.eg. 2. Orthopedics and Traumatology Department, Tanta Faculty of Medicine, Tanta University, Egypt. Electronic address: ashraf.mohamed@med.tanta.edu.eg.
Abstract
BACKGROUND: Around age 11-15 years, a forced external rotation of the foot in a supination or a medial rotation of the leg on the fixed foot usually is responsible for an avulsion injury to the anterolateral epiphysis, known as Tillaux fracture. Ligamentous injuries are rare in children because ligaments are stronger than is the growth plate that frequently is injured. OBJECTIVE: The aim of this study was to present the clinical outcome until the end of growth after surgical treatment for displaced adolescent Tillaux fractures. PATIENTS AND METHODS: 13 patients with Tillaux fractures in the adolescent age group. Patient`s age ranged (12-17 years) with an average 13.4 years. Of those 13 patients, there were 9 females and 4 males. RESULTS: Fracture union was obtained in all cases (100%) and was assed radiologically when X-ray check-ups in all projections showed the significant presence of trabeculation crossing the fracture, without pain and functionally using the American Orthopedic Foot and Ankle Society (AOFAS) score of the ankle joint. Overall average score was 97 ranged 95-100. There was no recorded post-operative complication. CONCLUSION: The plain radiographs of patients with an avulsion injury of anterolateral tubercle (Tillaux fragment) should be carefully examined for evidence of syndesmotic widening. If there is any doubt, CT scans is helpful. If fracture displacement was greater than 2 mm, a surgical intervention is recommended to restore the normal anatomy of the ankle joint. Anatomically reduced Tillaux fractures at adolescent age group either by closed or opened means, followed by post-operative plaster cast immobilization will lead to excellent results.
BACKGROUND: Around age 11-15 years, a forced external rotation of the foot in a supination or a medial rotation of the leg on the fixed foot usually is responsible for an avulsion injury to the anterolateral epiphysis, known as Tillaux fracture. Ligamentous injuries are rare in children because ligaments are stronger than is the growth plate that frequently is injured. OBJECTIVE: The aim of this study was to present the clinical outcome until the end of growth after surgical treatment for displaced adolescent Tillaux fractures. PATIENTS AND METHODS: 13 patients with Tillaux fractures in the adolescent age group. Patient`s age ranged (12-17 years) with an average 13.4 years. Of those 13 patients, there were 9 females and 4 males. RESULTS:Fracture union was obtained in all cases (100%) and was assed radiologically when X-ray check-ups in all projections showed the significant presence of trabeculation crossing the fracture, without pain and functionally using the American Orthopedic Foot and Ankle Society (AOFAS) score of the ankle joint. Overall average score was 97 ranged 95-100. There was no recorded post-operative complication. CONCLUSION: The plain radiographs of patients with an avulsion injury of anterolateral tubercle (Tillaux fragment) should be carefully examined for evidence of syndesmotic widening. If there is any doubt, CT scans is helpful. If fracture displacement was greater than 2 mm, a surgical intervention is recommended to restore the normal anatomy of the ankle joint. Anatomically reduced Tillaux fractures at adolescent age group either by closed or opened means, followed by post-operative plaster cast immobilization will lead to excellent results.