Tillaux Fracture in Adults. Case Report and Literature Review

  • Juan Ignacio Pérez Abdala Trauma Sector, Institute of Orthopedics and Traumatology “Prof. Dr. Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina https://orcid.org/0000-0002-5398-6876
  • Guido Carabelli Trauma Sector, Institute of Orthopedics and Traumatology “Prof. Dr. Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina https://orcid.org/0000-0002-7049-0688
  • Franco L. De Cicco Trauma Sector, Institute of Orthopedics and Traumatology “Prof. Dr. Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina https://orcid.org/0000-0001-9844-140X
  • Carlos Federico Sancineto Sector Trauma, Instituto de Ortopedia y Traumatología "Prof. Dr. Carlos E. Ottolenghi", Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina http://orcid.org/0000-0002-5190-4312
  • Jorge Daniel Barla Trauma Sector, Institute of Orthopedics and Traumatology “Prof. Dr. Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina http://orcid.org/0000-0001-9233-5278
  • Danilo Taype Zamboni Trauma Sector, Institute of Orthopedics and Traumatology “Prof. Dr. Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina http://orcid.org/0000-0001-8293-9879
DOI: https://doi.org/10.15417/issn.1852-7434.2023.88.1.1657
Keywords: Adult, fracture fixation, Tillaux fracture, ankle

Abstract

Introduction: The fracture of the anterolateral region of the distal tibial epiphysis, or Tillaux-Chaput tubercle, is known as Tillaux fracture. It is an exceptional entity in adults, but it has significant importance because it affects the tibiotalar joint surface, the stability of the syndesmosis, and, in some cases, the fibular notch. We present the case of a 45-year-old woman treated in the Emergency Service due to rotational trauma to the left ankle and functional impairment and pain in the anterolateral region of the ankle. The radiographs led to the suspicion of a fracture line corresponding to the Tillaux-Chaput tubercle. Therefore, a CT scan was performed, which confirmed a Tillaux fracture with a >2 mm displacement and involvement of the fibular notch. The patient underwent open reduction and internal fixation. The fracture consolidated after 3 months. One year after surgery, her clinical and functional status was excellent. Conclusion: Diagnostic suspicion through meticulous physical examination and anamnesis and confirmation by imaging studies are essential for the proper management of rare fracture patterns, such as Tillaux fractures.

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Author Biographies

Juan Ignacio Pérez Abdala, Trauma Sector, Institute of Orthopedics and Traumatology “Prof. Dr. Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina
Trauma Sector, Institute of Orthopedics and Traumatology “Prof. Dr. Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina
Guido Carabelli, Trauma Sector, Institute of Orthopedics and Traumatology “Prof. Dr. Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina
Trauma Sector, Institute of Orthopedics and Traumatology “Prof. Dr. Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina
Franco L. De Cicco, Trauma Sector, Institute of Orthopedics and Traumatology “Prof. Dr. Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina
Trauma Sector, Institute of Orthopedics and Traumatology “Prof. Dr. Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina
Carlos Federico Sancineto, Sector Trauma, Instituto de Ortopedia y Traumatología "Prof. Dr. Carlos E. Ottolenghi", Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
Médico de Planta del Sector de Trauma, Instituto de Ortopedia y Traumatología "Prof. Dr. Carlos E. Ottolenghi", Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina.
Jorge Daniel Barla, Trauma Sector, Institute of Orthopedics and Traumatology “Prof. Dr. Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina
Head of Trauma Sector, Institute of Orthopedics and Traumatology “Prof. Dr. Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina
Danilo Taype Zamboni, Trauma Sector, Institute of Orthopedics and Traumatology “Prof. Dr. Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina
Trauma Sector, Institute of Orthopedics and Traumatology “Prof. Dr. Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina

References

Wuerz TH, Gurd DP. Pediatric physeal ankle fracture. J Am Acad Orthop Surg 2013;21(4):234-44.

https://doi.org/10.5435/JAAOS-21-04-234

Blackburn EW, Aronsson DD, Rubright JH, Lisle JW. Ankle fractures in children. J Bone Joint Surg Am

;94(13):1234-44. https://doi.org/10.2106/JBJS.K.00682

Tourné Y, Molinier F, Andrieu M, Porta J, Barbier G. Diagnosis and treatment of tibiofibular syndesmosis lesions

[published correction appears in Orthop Traumatol Surg Res. 2022 Apr;108(2):103237]. Orthop Traumatol Surg

Res 2019;105(8S):S275-S286. https://doi.org/10.1016/j.otsr.2019.09.014

Rammelt S, Bartoníček J, Kroker L. Pathoanatomy of the anterolateral tibial fragment in ankle fractures. J Bone

Joint Surg Am 2022;104(4):353-63. https://doi.org/10.2106/JBJS.21.00167

Ali Al-Ashhab ME, Mahmoud Mohamed AA. Treatment for displaced Tillaux fractures in adolescent age group.

Foot Ankle Surg 2020;26(3):295-8. https://doi.org/10.1016/j.fas.2019.04.001

Feng SM, Sun QQ, Wang AG, Li CK. “All-Inside” arthroscopic treatment of Tillaux-Chaput fractures: Clinical

experience and outcomes analysis. J Foot Ankle Surg 2018;57(1):56-9. https://doi.org/10.1053/j.jfas.2017.07.020

Kumar N, Prasad M. Tillaux fracture of the ankle in an adult: a rare injury. J Foot Ankle Surg 2014;53(6):757-8.

https://doi.org/10.1053/j.jfas.2014.06.010

Sharma B, Reddy IS, Meanock C. The adult Tillaux fracture: one not to miss. BMJ Case Rep

;2013:bcr2013200105. https://doi.org/10.1136/bcr-2013-200105

Oak NR, Sabb BJ, Kadakia AR, Irwin TA. Isolated adult Tillaux fracture: a report of two cases. J Foot Ankle Surg

;53(4):489-92. https://doi.org/10.1053/j.jfas.2014.03.012

Marsh JL, Buckwalter J, Gelberman R, Dirschl D, Olson S, Brown T, et al. Articular fractures: does an anatomic

reduction really change the result? J Bone Joint Surg Am 2002;84(7):1259-71. PMID: 12107331

Crawford AH. Triplane and Tillaux fractures: is a 2 mm residual gap acceptable? J Pediatr Orthop 2012;32Suppl 1:S69-S73. https://doi.org/10.1097/BPO.0b013e31824b25a1

Sferopoulos N. Common errors related to the Tillaux fracture. Res Rev Orthop 2018;2(2):10-3. Disponible en:

https://www.researchgate.net/publication/330244587_Common_Errors_Related_to_the_Tillaux_Fracture

Millán-Billi A, Fa-Binefa M, Gómez-Masdeu M, Carrera I, De Caso J. Tillaux fracture in adults - Case report and

review of literature. J Clin Orthop Trauma 2022;27:101809. https://doi.org/10.1016/j.jcot.2022.101809

Lampridis V, Gougoulias N, Sakellariou A. Stability in ankle fractures: Diagnosis and treatment. EFORT Open Rev 2018;3(5):294-303. https://doi.org/10.1302/2058-5241.3.170057

Birnie MFN, van Schilt KLJ, Sanders FRK, Kloen P, Schepers T. Anterior inferior tibiofibular ligament avulsion

fractures in operatively treated ankle fractures: a retrospective analysis. Arch Orthop Trauma Surg 2019;139(6):787-93. https://doi.org/10.1007/s00402-019-03138-2

Gómez JT, Torrent Gómez J, Castillón Bernal P, Anglès Crespo F. Fractura de Tillaux del adulto: a propósito de un caso. Revista del Pie y Tobillo 2012;26:43-6. https://doi.org/10.1016/S1697-2198(16)30056-8

Horn BD, Crisci K, Krug M, Pizzutillo PD, MacEwen GD. Radiologic evaluation of juvenile tillaux fractures of the

distal tibia. J Pediatr Orthop 2001;21(2):162-4. https://doi.org/10.1097/01241398-200103000-00005

Published
2023-02-17
How to Cite
Pérez Abdala, J. I., Carabelli, G., De Cicco, F. L., Sancineto, C. F., Barla, J. D., & Taype Zamboni, D. (2023). Tillaux Fracture in Adults. Case Report and Literature Review. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 88(1), 107-112. https://doi.org/10.15417/issn.1852-7434.2023.88.1.1657
Issue
Vol 88 No 1 (2023): SAMECIPP
Section
Case Presentations
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