Displaced juvenile Tillaux fractures

Abstract

SummaryBackgroundApproximately 15 % of all juvenile injuries of the long bones involve the epiphyseal growth plate, and 2.9 % of these are juvenile Tillaux fractures. The Tillaux fracture is of great importance because it involves a major weight-bearing articular surface. Treatment protocols in the literature are not uniform for this kind of fracture, and numerous case reports can be found describing various treatment methods. The aim of this study was to present the clinical outcome at long-term follow-up after treatment of displaced Tillaux fractures.MethodsIn all, 168 children and adolescent patients with physeal injuries of the distal tibia were treated from 2003 to 2012. Seven patients were identified as having Tillaux fractures requiring surgical treatment and therefore were included in our study and evaluated retrospectively.ResultsSeven patients with Tillaux fractures underwent surgical reconstruction by open or closed reduction. Excellent results were achieved in 90 % of the patients, with a mean Foot and Ankle Score at the last follow-up of 98.71.ConclusionAnatomical reduction is required for every displaced epiphyseal fracture via open reduction and internal fixation, especially in cases with ≥2 mm fragment displacement. Plaster cast immobilization and non-weight-bearing mobilization for at least 4 weeks might be a good way of ensuring optimal surgical results and preventing complications.

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

“…Studies suggesting open reduction and internal fixation advocate immobilization for at least four weeks postoperatively. [3,18] The current study's results were similar, with two weeks of immobilization applied during patient follow-up based upon the patient's age concerning rehabilitation and the status of the fracture. In addition, we wanted to prevent Achilles tendon and joint contracture during the follow-up of immobilized intra-articular fractures, prevent reflex sympathetic dystrophy, and facilitate rehabilitation, [15,24] In our opinion, early removal of the splint and the start of rehabilitation do not alter functional results in the long term, but it facilitates rehabilitation in the short term and may allow them to return to daily activities more easily.…”

“…Tiefenboeck et al [3] reported 90% excellent results in their study, which included seven patients undergoing open surgical internal fixation. They reported limitation of motion in the ankle as a complication in one patient.…”

“…Adölasanlarda deplase Tillaux-Chaput kırıkların mini açık cerrahi ile yönetimi Dr. Muhammet Salih Ayas, 1 Dr. Ahmet Köse, 1 Dr. Eşref Terzi, 1 Dr. Recep Dincer, 2 Dr. Murat Topal, 3 Dr. Erdem Yunus Uymur, 1 Dr. Ali Şahin 1 1 Erzurum Bölge Eğitim ve Araştırma Hastanesi, Ortopedi ve Travmatoloji Kliniği, Erzurum 2 Süleyman Demirel Üniversitesi Tıp Fakültesi, Ortopedi ve Travmatoloji Anabilim Dalı, Isparta 3 Kastamonu Üniversitesi Tıp Fakültesi, Ortopedi ve Travmatoloji Anabilim Dalı, Kastamonu AMAÇ: Tillaux-Chaput kırıkların optimal tedavisi tartışmalıdır. Bu çalışma ile, mini-açık cerrahi ile tedavi edilen olgularımızın sonuçları (açık redüksiyon ve internal fiksasyon); etkililik ve komplikasyonlar açısından, diğer prosedürleri (açık, perkütan ve artroskopi destekli) literatür verileri ile karşılaştırmak ve de birincil tedavinin mini açık cerrahi olup olmadığı sorusuna bir cevap aramaktır.…”

“…[2] Triplane and Tillaux fractures consist of a multiplanar fracture pattern resulting from supination external rotation and compression stress. [3] Since these fractures typically occur after tibial growth has concluded, they rarely result in growth arrest. [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.…”

Coracoclavicular fixation techniques for Neer IIb and “extralateral” fractures of the distal clavicle: a systematic review

“…Cho et al 5 suggested coracoclavicular stabilization techniques or transacromial intramedullary fixation for this type of fractures, whereas others have suggested traditional hardware (locking plates) but with additional coracoclavicular augmentation. 9,35,36 The limitations of our systematic review lie with those of the included studies. All included studies were retrospective cohort, or case series, with a moderate to high risk of bias, deeming the level of evidence of our review as low.…”