Imaging Case of the Week 240 Answer

The AP x-ray of the left ankle shows a subtle fracture line through the distal tibial epiphysis – a Tillaux fracture. The lateral ankle x-ray shows moderate joint effusion.

Tillaux fracture is a specific type of injury that occurs in adolescents; it is a Salter-Harris III fracture of the distal tibial epiphysis.

CT scan of the ankle ruled out a tri-plane fracture, i.e. a Salter-Harris IV injury with a vertical component through the distal tibial metaphysis.

This patient was managed conservatively.

Further information on Tillaux fractures can be found here.