Imaging Case of the Week 143 Interpretation

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This patient has a Tillaux fracture of the ankle. There is a Salter-Harris type III fracture through the anterolateral aspect of the distal tibial epiphysis. The lateral ankle view does not show a fracture through the metaphysis. There is extensive soft tissue swelling around the joint.

Tillaux fractureA CT scan confirmed the fracture and also showed significant displacement of the fracture fragment.

Right ankle CTA 3D CT image from the same patient:

Right ankle 3D CTThis patient was referred to the orthopaedic specialist and underwent ORIF.

Tillaux fracture:

  • Salter-Harris type III fracture of the anterolateral tibial epiphysis
  • Occurs in older children and adolescents
  • Results from an abduction and external rotational injury to the ankle
  • Surgically managed if the fracture fragments are displaced by more than 2 mm or if there is articular surface incongruity on CT; all cases need a referral to an orthopaedician for further management.

Reference: http://www.orthobullets.com/pediatrics/4028/tillaux-fractures