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Tillaux Fractures: Anterior Tibia-Fibula Ligament Avulsion, Sports Medicine

David Johnson, MD and Michael Y. Yang, MD Reviewed 04/2019
 


BASICS

DESCRIPTION

  • Salter-Harris (SH) type III avulsion fracture of the lateral distal tibial epiphysis

  • Occurs with traumatic external rotatory force pulling on the anterior inferior talofibular ligamen...

DIAGNOSIS

HISTORY

  • Forceful supination and external rotation with compression stress

  • Also seen with internal rotation of the lower leg on a firmly planted foot

  • Acute anterolateral ankle pain

  • Reported pain ...

TREATMENT

Nonsurgical: 
  • Initial: immobilization, non–weight-bearing, ice, elevation, acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs)

  • Nondisplaced or minimally displaced fractures (<2 ...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

For nonsurgically treated: 
  • Follow-up with x-rays, typically every 2 wk

  • Evaluate for varus or valgus deformity.

  • After 4 wk of immobilization, progress to walking cas...

REFERENCES

1
Cassas KJ, Jamison JP. Juvenile Tillaux fracture in an adolescent basketball player. Phys Sportsmed.  2005;33(2):30–33.
2
Spiegel PG, Cooperman DR, Laros GS. Epiphyseal fractures of the...

ADDITIONAL READING

Habusta SF, Griffin EE. Fractures, Tillaux. Treasure Island, FL: StatPearls Publishing; 2018. 

CLINICAL PEARLS

  • Possible complications include posttraumatic arthritis and asymmetric physeal growth.

  • If treated nonoperatively, 4 wk non–weight-bearing followed by 2 to 4 wk in a walking cast or cam w...

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