Management of Tillaux Fractures

  • Sheriff AkinleyeEmail author
  • Mara Karamitopoulos
Living reference work entry


Adolescents are susceptible to relatively uncommon Salter Harris III fractures of the distal tibia, known as Tillaux fractures. This is due to the fact that the closure of the distal tibia physis occurs over an 18-month period between the ages of 12 and 15 years. Thus, in the setting of an external rotation force to the distal tibia during this specific period of time, a Tillaux fracture can occur. Following closed reduction in a long leg cast, computed tomography (CT) scans are needed to adequately assess joint congruity. This is critical, as a gap of 2 mm or more can lead to residual deformity of the articular surface resulting in premature degenerative arthritis of the ankle joint. Therefore, in order to ensure accuracy of fixation, these periarticular fractures are usually treated with cannulated screws. Regardless of the treatment modality, anatomic reduction of the articular surface is the goal of care.

References and Suggested Reading

  1. Canale TS (1992) Fractures and dislocations in children. In: Crenshaw AH (ed) Campbell’s operative orthopedics. Mosby, St. Louis, pp 1213–1218Google Scholar
  2. Simon WH, Floros R, Schoenhaus H et al (1989) Juvenile fracture of Tillaux: a distal tibial epiphyseal fracture. J Am Podiatr Med Assoc 79(6):295–299CrossRefGoogle Scholar
  3. Leitch JM, Cundy PJ, Paterson DC (1990) Three-dimensional imaging of a juvenile Tillaux fracture. J Pediatr Orthop 9(5):602–603CrossRefGoogle Scholar
  4. Kling TF, Jr. (1990) Operative treatment of ankle fractures in children. Orthop Clin North Am 21(2):381–392.Google Scholar
  5. Duchesneau S, Fallat LM (1996) The Tillaux fracture. J Foot Ankle Surg 35(2):127–133CrossRefGoogle Scholar
  6. Barmada A, Gaynor T, Mubarak SJ (2003) Premature physeal closure following distal tibia physeal fractures: a new radiographic predictor. J Pediatr Orthop 23(6):733–739CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Orthopaedic SurgeryMaimonides Medical CenterBrooklynUSA

Section editors and affiliations

  • L. Reid Nichols
    • 1
  1. 1.Nemours/Alfred I. duPont Hospital for ChildrenWilmingtonUSA

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