Tillaux Fracture S89.129A 823.80

synonyms: Salter-Harris type II distal tibial fracture

Juvenile Tillaux Fracture ICD-10

• S89.129A Salter-Harris Type II physeal fracture lower end unspecified tibia, initial closed

Juvenile Tillaux Fracture ICD-9

• 823.80(closed fracture of unspecified part of tibia)

Juvenile Tillaux Fracture Etiology / Epidemiology / Natural History

• A Salter-Harris type II distal tibial fracture involving the anterolateral distal tibia.
• A form of transitional ankle fracture related to the asymmetric pattern of distal tibial physeal closure.
• Occur in early adolescence
• Thought to be caused by external rotation forces.

Juvenile Tillaux Fracture Anatomy

• Fracture results from avulsion by the anterior tibiofibular ligament.
• Distal tibial growth plate closure starts anteromedially, progresses posteriorly and laterally and finishes anterolaterally.

Juvenile Tillaux Fracture Clinical Evaluation

• Pain and deformity in the ankle, degree dependent on fracture severity.
• Evaluate skin integrity, swelling, and neurovascular status of the leg/foot.

Juvenile Tillaux Fracture Xray / Diagnositc Tests

• A/P, lateral and mortise views of the ankle. Appears like a Tillaux fracture on A/P and mortise views.
• CT generally indicated. Demonstrates that fracture line does not extend through the anterior cortex. (Horn BD, JPO 2001;21:162).
• MRI generally not indicated although can provide information on ligamentous and physeal injury. (Lohman M, Skeletal Tadiol 2001;30:504).

Juvenile Tillaux Fracture Classification / Treatment

• Nondisplaced: immobilization
• Displaced (>2mm): open or closed reduction and fixation with cannulated screws

Juvenile Tillaux Fracture Associated Injuries / Differential Diagnosis

• Pediatric Distal Tibial Fracture
• Triplane Ankle Fracture
• Adolescent Pilon Fracture
• Incisural Ankle Fracture

Juvenile Tillaux Fracture Complications

• Delayed union, nonunion
• Malunion
• Growth arrest (uncommon)
• Arthritis
• Osteonecrosis of the distal tibial epiphysis
• Compartment syndrome

Juvenile Tillaux Fracture Follow-up Care

Juvenile Tillaux Fracture Review References

• Rockwood and Wilkin's Fractures in Children 6th ed, 2006