Fratura triplanar do tornozelo
Keywords:
Tibial fracture, Ankle fracture, Salter Harris fracture, Growth plateAbstract
Tillaux´s fracture depicts proximally 3% of all physeal fractures of juvenile long bones. They occur due to the assimetric closure of the distal tibia growth plate, this allows for the occurrence of a Salter Harris III (Tillaux) and Salter Harris IV (triplane). Treatment can be conservative in the non-displaced fractures or less than 2mm deviation and surgical in the displaced fractures. Correct treatment is important to avoid complications like: angular deformity, early arthrosis, low limbs discrepancy and articular stiffness. Treatment choice must be based on the fracture pattern.
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References
Koury SI, Stone CK, Harrell G, La ChariteDD. Recognitionand management of Tillaux fractures in adolescents. Pediatr Emerg Care. 1999;15(1):37-9.
Landin LA, Danielsson LG. Children’s ankle fractures. Classification and epidemiology. Acta Orthop Scand. 1983;54(4): 634640
Stefanich RJ, Lozman J. The juvenile fracture of Tillaux. Clin Orthop Relat Res. 1986 Sep;(210):219-27.
Spiegel PG, Cooperman DR, Laros GS. Epiphyseal fractures of the distal ends of the tibia and fibula. A retrospective study of two hundred and thirty-seven cases in children. J Bone Joint
Surg Am. 1978 Dec;60(8):1046-50.
Crawford AH. Triplane and Tillaux fractures: is a 2mm residual gap acceptable? J Pediatr Orthop. 2012;32(Suppl1):S69-S73.
Jay Cummings R. Distal tibial and fibula fractures. In: Beaty J, Kasser J, editors. Rockwood and Wilkins fractures in children. 6ted. Philadelphia: Lippincott Williams & Wilkins; 2006. p.
-128.
Lynn MD. The triplane distal tibial epiphyseal fracture. Clin Orthop Relat Res. 1972 Jul-Aug;86:187-90.
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):162164.
Liporace FA, Yoon RS, Kubiak EN, Parisi DM, Koval KJ, Feldman DS, Egol KA. Does adding computed tomography change the diagnosis and treatment of Tillaux and triplane pediatric ankle fractures? Orthopedics. 2012 Feb 17;35(2):e208-12.