Tillaux-Chaput avulsion fracture

Tillaux-Chaput avulsion fracture
Classification and external resources
ICD-10	S82.3
AO	43-A1

A Tillaux fracture is a Salter–Harris type III fracture through the anterolateral aspect of the distal tibial epiphysis.^[1] It occurs in older adolescents between the ages of 12 and 15 when the medial epiphysis had closed but before the lateral side has done so,^[2] due to an avulsion of the anterior tibiofibular ligament, at the opposite end to a Wagstaffe-Le Fort avulsion fracture

Etymology

This fracture pattern is named after Paul Jules Tillaux, a French Anatomist and Surgeon (1834-1904).

Mechanism

The fracture commonly results from an abduction-external rotation force, causing the anterior tibiofibular ligament to avulse the anterolateral corner of the distal tibial epiphysis resulting in a Salter Harris Type III fracture.

Epidemiology

It occurs commonly in adolescents and older children. However, it does occur rarely in adults though it may be under reported because of difficulty in diagnosis.^[3]

Pathology

It occurs in older children at the end of growth. Variability in fracture pattern is due to progression of physeal closure as anterolateral part of distal tibial physis is the last to close. When the lateral physis is the only portion not fused, external rotation may lead to Tillaux or Triplane fractures.

Treatment

If the displacement at fracture is less than 2 mm, it may be managed conservatively. However, displacement of more than 2mm requires open reduction and internal fixation with 1-2 lag screws to prevent onset of post-traumatic osteoarthritis.

References

↑ "Wheeless Online". Retrieved 30 October 2014.
↑ "Radiopaedia". Retrieved 30 October 2014.
↑ Kumar, Narinder; Prasad, Manish (2014). "Tillaux Fracture of the Ankle in an Adult: A Rare Injury". The Journal of Foot and Ankle Surgery 53 (6): 757–8. doi:10.1053/j.jfas.2014.06.010. PMID 25128312.

Fractures and cartilage injuries (Sx2, 800–829)

General

Humerus fracture:	Supracondylar Holstein–Lewis fracture

Forearm fracture:	Ulnar fracture Monteggia fracture Hume fracture Radius fracture/Distal radius Galeazzi Colles' Smith's Barton's Essex-Lopresti fracture

Hand fracture

Pelvic fracture

Leg

Tibia fracture:	Bumper fracture Segond fracture Gosselin fracture Toddler's fracture Pilon fracture Plafond fracture Tillaux fracture

Fibular fracture:	Maisonneuve fracture Le Fort fracture of ankle Bosworth fracture

Combined tibia and fibula fracture:	Trimalleolar fracture Bimalleolar fracture Pott's fracture

Crus fracture:	Patella fracture

Femoral fracture:	Hip fracture

Foot fracture

Orthopaedic eponyms

Medical eponyms

Fractures	Bankart's fracture Barton's fracture Bennett's fracture Bosworth fracture Chance fracture Chopart's fracture-dislocation Colles' fracture Dupuytren's fracture Duverney fracture Essex-Lopresti fracture Galeazzi fracture Gosselin fracture Holstein–Lewis fracture Holdsworth fracture Hutchinson's fracture Hoffa fracture Hume fracture Jefferson fracture Jones fracture Lisfranc fracture Maisonneuve fracture Malgaigne's fracture Monteggia fracture Moore's fracture Pipkin fracture-dislocation Plafond fracture Pott's fracture Rolando fracture Segond fracture Shepherd's fracture Smith's fracture Stieda fracture Tillaux-Chaput avulsion fracture Wagstaffe-Le Fort avulsion fracture Volkmann avulsion fracture

Classifications	Bado classification Danis–Weber classification Denis classification Evans-Jensen classification Ficat classification Frykman classification Garden classification Gartland classification Gruen zone Gustilo open fracture classification Haruguchi classification Hawkin's classification Herbert classification Herscovici classification Ideberg classification Jupiter and Mehne classification Lauge-Hansen classification Le Fort fracture of skull Loder classification Mayfield classification Milch classification Neer classification Pipkin classification Pauwel's classification Riseborough and Radin classification Ruedi-Allgower classification Salter–Harris fracture Schatzker classification of tibia plateau fractures Tile classification Schatzker classification of olecranon fractures Sanders classification Seddon classification Seinsheimer classification Schenck classification Teisen classification Tscherne classification Thompson and Epstein classification Vancouver classification Wassel classification Winquist and Hansen classification Young-Burgess classification

Procedures	Akin osteotomy Bankart repair Broström procedure Brunelli procedure Cotrel–Dubousset instrumentation Cunningham Shoulder Reduction Darrach's procedure Darrah procedure Evans technique Girdlestone's Procedure Keller procedure Kocher manoeuvre Krukenberg procedure Latarjet procedure Mumford procedure Ponseti method Swanson's Arthroplasty Tommy John surgery Weil's Osteotomy Weaver–Dunn procedure Zadek's procedure

Anatomy	Gerdy's tubercle Guyon's Canal Harrison's groove Haversian canal Humphrey's ligament Lisfranc joint Lisfranc ligament Lister's tubercle Martin-Gruber Anastomosis Schmorl's nodes Volkmann's canals

CPRs	Harris Hip Score Kocher criteria Mirel's Score Rowe Score

Clinical signs	Andersson lesion Baastrup's sign Bouchard's nodes Boutonniere deformity Coopernail's sign Codman triangle Destot's sign Frankel's sign Heberden's node Kanavel's sign Larrey's sign Trendelenburg gait

Clinical examination	Allis test Apley grind test Apley scratch test Barlow's maneuver Clarke's test Cozen's test Cotton test Durkan's test Finkelstein's test Froment's sign Jobe's test Kapandji score Gaenslen's test Galeazzi test Gerber's test Hawkins–Kennedy test Hubscher's maneuver Lachman test Lasègue's sign McMurray test Mulder's sign Neer impingement sign O'Brien's test Ober's test Ortolani test Patrick's test Phalen maneuver Simmonds' test Schober's test Speed's test Thomas test Thompson test Tinel sign Trendelenburg's sign Yergason's test Waddell's signs Watson's test Wilson test

Congenital conditions	Albers-Schonberg disease Albright's hereditary osteodystrophy Antley–Bixler syndrome Apert syndrome Beals syndrome Bechterew's Bruck syndrome Camurati–Engelmann disease Catel–Manzke syndrome Cole carpenter syndrome Conradi–Hünermann syndrome Currarino syndrome Ehlers–Danlos syndrome Eiken syndrome Ellis–van Creveld syndrome Erlenmeyer flask deformity Fairbanks disease Hajdu–Cheney syndrome Jansen's metaphyseal chondrodysplasia Kashin–Beck disease Klippel–Feil syndrome Klippel–Trénaunay–Weber syndrome Kniest dysplasia Lobstein syndrome Madelung's deformity Maffucci syndrome Marfan syndrome Marie-Strümpell disease Marshall syndrome Marshall–Smith syndrome McCune–Albright syndrome Melnick–Needles syndrome Morton's toe Ollier disease Rett syndrome Rubinstein–Taybi syndrome Scheuermann's disease Schwartz–Jampel syndrome Silver–Russell syndrome Teunissen–Cremers syndrome Trevor disease Wiedemann syndrome

Acquired conditions	Baker's cyst Bankart lesion Barré–Liéou syndrome Blount's disease Brodie abscess Chandler's disease De Quervain syndrome Dupuytren's contracture Ewing's sarcoma Freiberg disease Garre's sclerosing osteomyelitis Gorham's disease Haglund's deformity Hill–Sachs lesion Iselin's disease Kashin–Beck disease Kienbock's disease Köhler disease Legg–Calvé–Perthes syndrome Morton's neuroma O'Donoghue's triad Osgood–Schlatter disease Paget's disease of bone Panner disease Perthes Lesion Preiser disease Sever's disease Stener lesion Sudeck's atrophy Tietze syndrome Volkmann's contracture

Orthopedic implants	Austin Moore prosthesis Baksi's prosthesis Charnley prosthesis Denis Browne bar Ender's nail Grosse-Kempf nail Harrington rod Herbert screw Kirschner wire Kuntscher nail Moore's pin Neer's prosthesis Rush nail Schanz screw Seidel nail Smith Peterson nail Steinmann pin Swanson prosthesis Talwalkar nail Thompson prosthesis

Orthopaedic instruments	Bryant's traction Charnley Retractor Darrach elevator Faraboeuf forceps Gigli saw Hohmann retractor Ilizarov apparatus Inge retractor Jungbluth forceps Matta forceps Taylor Spatial Frame Thomas splint Verbrugge forceps Volkmann retractor Weber forceps

Surgical approaches	Hardinge lateral approach to the hip Moore or Southern posterior approach to the hip Smith-Petersen anterior approach to the hip Watson-Jones anterolateral approach to the hip

Radiographic signs	Baumann's angle Blumensaat's line Bohler's angle Cobb angle Fairbank's changes Gilula's Lines Harris lines Hilgenreiner's line Kellgren-Lawrence grading scale Klein's line Loosers zone Pauwel's angle Perkin's line Shenton's Line Southwick angle Thurstan Holland sign Trethowan's sign Terry-Thomas sign

Radiographic projections	Judet view Broden's view

Principles	Wolff's law Hueter-Volkmann law Charley's principles of three-point fixation

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