The Tillaux fracture describes a specific bone, location, and amount of damage done. The bone affected is the tibia (the large “shin” bone in the lower leg). The fracture is at the bottom of the tibia just above the ankle. The fracture affects the front and side of the bone and extends through the growth plate right into the joint.
A strong force along the outside of the ankle tears the ligament that attaches to the growth plate. Without this ligament to protect the bone, the force of the injury extends the fracture line straight up into the joint.
The first tell-tale sign of a Tillaux fracture is the fact that the child cannot put any weight on the foot/leg. Swelling and bruising are visible along the front of the ankle. There is exquisite tenderness where the fracture is located and the entire ankle hurts.
X-rays and CT scans are used to show the full extent of the injury. These imaging studies are helpful when planning surgery. If there is displacement (separation) of the bones at the fracture site, then more extensive surgery with fixation using pins, screws, and/or wires may be required. Nondisplaced fractures may be managed with a non-weight-bearing cast.
With early diagnosis and appropriate treatment, long-term results are reportedly good. The closer the child/teen is to full growth, the less risk of damage to the growth plate. Sometimes early arthritis develops but this occurs later in life and does not prevent return to participation in sports activities after rehabilitation.