Dr. Ebraheim’s educational animated video describing growth plate fractures of the distal tibia - Tillaux Fracture.
Please forgive the error with fibular avulsion. Classification should have read (Lauge Hansen).
In adults, the ligaments are weaker than the bone. The anterior tibiofibular ligament in adults is torn first in the majority of ankle fractures. In pediatrics, the growth plate is weaker and it can become avulsed. An avulsion injury is rarely seen in adults because the ligament gives out instead of avulsion of the bone.
Tillaux fracture
It occurs in adolescents, after the middle and medial parts of the epiphyseal plate close, and before the lateral part is closed (usually around 12 to 15 years of age).
The lateral part of the growth plate remains open, which could allow for an avulsion fracture at the attachment of the anterior tibiofibular ligament.
External rotation force causes an avulsion of the distal tibial epiphyseal plate anterolaterally. Further lateral rotation displaces the fracture and may be associated with fraction of the lateral malleolus.
Treatment
Reduction & fixation
If displaced 2 mm or more
Fixation can be done from either lateral to medial or medial to lateral.
Wagstaffe’s fracture is an avulsion of the anterior portion of the fibula by the anterior tibiofibular ligament. this type of injury is associated with supination-external rotation type injuries (Lauge-Hansen). This type of injury typically occurs in adult patients.
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