“All-Inside” Arthroscopic Treatment of Tillaux-Chaput Fractures: Clinical Experience and Outcomes Analysis

Abstract

We investigated all-inside ankle arthroscopy for Tillaux-Chaput fractures. We retrospectively evaluated 19 patients (12 males [63.2%] and 7 [36.8%] females; 11 right [57.9%] and 8 left [42.1%] ankles) treated from May 2013 to January 2016. Their mean age was 28.1 (range 10 to 55) years. Sixteen (84.2%) had single Tillaux-Chaput fractures and 3 (15.8%) had combined proximal fibular fractures; 17 (89.5%) were diagnosed radiographically and 2 (10.5%) by computed tomography. Anterolateral and anteromedial ankle arthroscopy was used for closed reduction and internal fixation with 1 or 2 Herbert screws. Joint function was evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale. All 19 patients healed by first intention without nerve, vessel, or tendon injuries. The follow-up was 19.0 (range 12 to 25) months; fracture union was achieved by 23.5 (range 12 to 36) weeks. At the last follow-up, the 19 patients had no restrictions in ankle function and range of motion, with no ankle or walking pain. The AOFAS score changed from 52.8 to 91.7 points, with an excellent/good rate of 100%. These results suggest that anterolateral and anteromedial all-inside ankle arthroscopy is a precise and effective method for closed reduction and internal fixation of Tillaux-Chaput fractures.

Arthroscopically Assisted Internal Fixation of Foot and Ankle Fractures: A Systematic Review

“…For ankle fractures, we identified a total of 17 studies. [2][3][4][5][6][7][8][10][11][12][13]16,27,29,[35][36][37][38] Among these, 2 were systematic reviews, 1 meta-analysis, 2 RCTs, 5 retrospective comparative studies, 4 retrospective series, 2 prospective series, and 1 case-control study. The studies reported a total of 952 patients.…”

“…Seven studies used the American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot score postoperatively, reporting an AOFAS mean score of 93.2 (range 85.4-96.9). 3,7,8,[10][11][12]36 Five studies reported the visual analog scale (VAS) score, with a mean score of 0.7 (range 0-1.03). 38 Two other comparative studies (n ¼ 112) reported that outcomes for AAORIF were similar to that of ORIF in the 13,37 In one study, arthroscopy was used intraoperatively to confirm anatomic articular reduction after ORIF.…”

Fratura de Tillaux não percebida e lesão por sindesmose em adultos: Redução e fixação artroscópica assistida

“…A tomografia computadorizada é mais precisa que as radiografias simples e permite uma melhor avaliação do deslocamento da fratura, padrão e congruência articular. 6 A artroscopia tem sido cada vez mais usada para auxiliar o tratamento cirúrgico de fraturas do tornozelo e para gerenciar complicações pós-traumáticas. 7 É uma ferramenta valiosa porque permite a visualização direta da superfície articular necessária para a redução anatômica, requer menor incisão e dissecção da pele, menos interrupções no suprimento sanguíneo ósseo e menos riscos de complicações da ferida, infecção, atraso na união e não união.…”

“…[2][3][4][5] As fraturas intra-articulares requerem redução e estabilização anatômicas para evitar complicações como instabilidade do tornozelo, dor no tornozelo e osteoartrite pós-traumática. 4,6 A artroscopia tem várias vantagens em relação às abordagens abertas, permitindo um tratamento menos agressivo das lesões associadas, melhora da redução intra-articular e com menos complicações. 7 Os autores relatam tratamento assistido por artroscopia de um caso raro de fratura de Tillaux em adulto, associado a lesão por sindesmose que foi inicialmente não percebida em um paciente com politrauma.…”

Surgical Management of Displaced Adolescent Tillaux Fractures with The Mini Open Technique

“…[4][5][6] tion is necessary for perfect results, [6,[10][11][12] Theoretically, there is a low risk of physis closure after surgery; however, this could not be confirmed by a post-operative study. [13][14][15] A review of the current literature revealed various series of open, percutaneous, and arthroscopy-assisted surgical procedures, [13,16,17] but no consensus regarding the management of these fractures. In the present study, the results of our cases treated with mini-open surgery (open reduction and internal fixation); concerning efficacy and complications to compare other procedures (open, percutaneous, and arthroscopy-assisted) with the literature data and to look for an answer to the question of whether the primary treatment can be a mini-open surgery.…”