Prof. Lascombes pediatric technique series continues with a Tillaux´ tubercle fracture

Pediatric trauma technique series with Prof. Lascombes continues with a treatment of the detached anterolateral tubercle in the right tibia.

A 14 years old girl with a twist of her right ankle following a gymnastic fall. X-rays demonstrated an articular fracture of the right distal tibia: the anterolateral tubercle (Tillaux’) is detached and displaced, as seen on AP and lateral X-rays. On the CT scan, the fragment is displaced of more than 2mm and requires a perfect reduction and internal fixation. In addition, a second fracture located on the posterolateral tibia.

Through a percutaneous anterolateral approach, the dissection of tendons allowed to reach the fractured anterior fragment. K-wire was inserted through the reduced fragment till the distal metaphysis of the tibia. Due to the age of the patient (end of growth), it was considered possible to cross the physis, which was almost mature. The fixation was done with partially threaded ActivaScrew™ Cannulated LAG.

Postoperatively an immediate immobilization was done with a splint, replaced three days later with a resin below the knee cast. Six weeks later, the range of motion of the right ankle was comparable with the left one. X-rays at 3 months follow-up showed an excellent bone union and the girl was allowed to return to all sports activities like before.

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