Adult Tillaux Fracture in Association with Volkmann and Maisonneuve Fratures: A Case Report

Mansur, Henrique; Lima, Thiago Coelho Paim; Gonçalves, César Barbosa; Castro, Isnar Moreira de

doi:10.7547/17-187

Cited by 7 publications

(6 citation statements)

References 9 publications

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“…A review of the literature yielded four articles on Tillaux fractures combined with other ankle injuries in adolescents and adults [5][6][7][8]. Yuan et al presented six cases of Tillaux fractures with ipsilateral medial malleolus fractures [5].…”

Section: Discussionmentioning

confidence: 99%

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Combined Tillaux and Bimalleolar Ankle Fracture in a Pediatric Patient: A Case Report

Helmig¹,

Choi²,

Silva³

2022

Cureus

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Adolescents are at risk of unique ankle fracture patterns due to closing physes. Transitional ankle fractures, in particular, are an entity specific to adolescent patients due to the asymmetrically open distal tibia physis. Transitional ankle fractures are rarely seen in combination with bimalleolar ankle fracture patterns. This case is of interest because the combined fracture pattern and the treatment method presented have not been previously reported in the literature to our knowledge. A 15-year-old female presented with right ankle pain after a fall while roller skating. Imaging demonstrated a right Tillaux fracture with ipsilateral displaced medial malleolus fracture and minimally displaced Weber C distal fibula fracture. The Tillaux fracture and medial malleolus fractures were treated with open reduction and internal fixation with partially threaded compression screws. The lateral malleolus remained minimally displaced and did not require operative fixation. The patient healed well with no complications. Transitional injuries of the ankle in adolescents have been reported in the literature; however, combined injuries are uncommon and lack representation in the current literature base. These combined injuries are important to be aware of, as missed injuries can result in long-term pain and disability.

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Section: Discussionmentioning

confidence: 99%

“…Multiple case reports detail combined Tillaux and Volkmann (avulsion fracture of the posterior inferior tibiofibular ligament) fractures in adolescents and adults [ 6 - 8 ]. This fracture pattern differs from that presented in our case but is similar in that it is a combined Tillaux fracture with additional ankle injury.…”

Section: Discussionmentioning

confidence: 99%

Combined Tillaux and Bimalleolar Ankle Fracture in a Pediatric Patient: A Case Report

Helmig¹,

Choi²,

Silva³

2022

Cureus

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“…6,[9][10][11][12][13] The vulnerable growth plate may not be fused until 14 years in girls and 18 years of age in boys. [6][7][8]11,14,15 The adult Tillaux fracture, also recognized as CTF, has a relative incidence of 12% in transmalleolar fractures but the frequency as isolated bony avulsion remains unknow. [16][17] It is classified as AO/OTA43B.…”

Section: Discussionmentioning

confidence: 99%

“…3 Masur et al treated a Tillaux, Volkmann and Maisonneuve fractures triad. 15 Treatment protocols for CTF described in the literature are highly variable as well as the techniques involved. The first reported cases are of a 50-years-old man treated conservatively by Protas et al and the first arthroscopically assisted reduction and fixation with screws performed by Miller.…”

Section: Discussionmentioning

confidence: 99%

“…Some authors advocate fixation of 1 mm displacements and others suggest greater functional benefit in an intra-articular gap greater than 2.5 mm. 4,5,[9][10][11]15,18,19,22 The potential complications are well recognized and range from pain to premature degenerative arthritis. 4,14,19 To the authors' knowledge, there are no previous studies reporting complications in adults with isolated CTF.…”

Section: Discussionmentioning

confidence: 99%

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The rare isolated adult Chaput-Tillaux fracture: two case reports and review of the literature

Pereira¹,

Rosa

Diniz

et al. 2020

Int J Res Orthop

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The authors present two isolated chaput-tillaux fractures in an adult skeleton. A high level of suspicion is required to prevent diagnostic failure. Computerized tomography scan detects hidden fractures and enables a more detailed preoperative assessment of each case. Most of the cases reported in the literature are associated with other ankle lesions. This typical juvenile pattern is rare in the adults and ideal treatment is yet to be determined.

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Ankle syndesmotic ligaments avulsion fractures: incidence in adult population

Yao,

Wang,

Pan

et al. 2024

J Orthop Surg Res

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Background Distal tibiofibular syndesmosis injury is often associated with ankle fractures in adults. Injuries to the anterior/posterior inferior tibiofibular ligament (AITFL/PITFL) may present as a mid-substance tear or as an avulsion at insertion. Tibial and fibular avulsion of the AITFL is known as Tillaux fracture and Wagstaffe fracture, respectively. Tibial avulsion of the PITFL is referred to as a Volkmann fracture, and fibular avulsion of the PITFL is still undefined and has not been reported yet. The aim of this study is to summarize the incidence of these four avulsions, that is, tibial and fibular avulsions of the AITFL and PITFL. Method Radiography and computed tomography (CT) imaging data of all adult patients with ankle fractures treated at our hospital between November 2010 and March 2023 were retrospectively analyzed. All ankle fractures were classified according to the Weber-AO and Lauge-Hansen classification systems by two experienced radiologists and two surgeons. The incidence of the four avulsions of the AITFL/PITFL was determined. Results In total, 1,770 ankle fractures in 1,758 patients were included in this study. The total incidence of avulsions at the four insertions of the AITFL/PITFL (occurring at one, two, or three insertions) was found to be 26.3% (465/1,770). Volkmann fracture had the highest incidence (19.9%, 353/1,770), and it was followed by Tillaux fracture (5.3%, 93/1,770), Wagstaffe fracture (3.3%, 59/1,770), and fibular avulsion of the PITFL (0.5%, 8/1,770). It is noteworthy that fibular avulsion of the PITFL has been reported here for the first time. The incidence of avulsion at one insertion was 23.6% (418/1770) and 2.7% (47/1770) at multiple insertions. Conclusion In adult ankle fractures, avulsion occurs at the four insertions of the AITFL/PITFL in more than 25% of patients. The tibial insertion of the PITFL had the highest incidence of avulsion among the four insertions, while the fibular insertion of the PITFL had the lowest. The four types of avulsions can be isolated or in association with other avulsions. Future research studies on these four types of avulsion fractures would help in accurate diagnosis, decision-making and treatment of ankle Syndesmosis injuries. Level of evidence Level III, retrospective cohort study.

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Adult Tillaux Fracture in Association with Volkmann and Maisonneuve Fratures: A Case Report

Cited by 7 publications

References 9 publications

Combined Tillaux and Bimalleolar Ankle Fracture in a Pediatric Patient: A Case Report

Combined Tillaux and Bimalleolar Ankle Fracture in a Pediatric Patient: A Case Report

The rare isolated adult Chaput-Tillaux fracture: two case reports and review of the literature

Ankle syndesmotic ligaments avulsion fractures: incidence in adult population

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