About a rare ankle injury in adults: Case report of a Tillaux fracture in adult

Abstract

Introduction and importance: Tillaux fracture occurs as a result of a forced external rotation mechanism involving the anterolateral tibial plafond. The occurrence of this fracture in adults is rare because the ligament usually disrupts before causing bone avulsion. Case presentation: We report the case of a 31-year-old man who, following a trauma in a foot-ball game, was admitted for management of an isolated anterolateral tibial plafond fracture. The diagnosis was made by X-ray, supported by CT scan, which investigated the fracture and excluded other associated injuries. Management was based on open reduction and direct screw fixation. After a 12-month follow-up, we obtained an excellent result. Clinical discussion: Tillaux fracture occurs most often in adolescents, more rarely in adults. The balance between ligament strength and bone strength explains the occurrence of this fracture in children, and the decrease in its incidence with the closure of the conjugation cartilage. Diagnosis is based on a complete radiological workup with standard radiographs and possibly a CT scan. Treatment is most often surgical using either direct screw fixation or plate osteosynthesis. Conclusion: Avulsion of the anterolateral distal tibia, called Tillaux fracture, is a rare entity requiring careful examination and a complete assessment in order to make the diagnosis and to eliminate other associated injuries. Although the literature reports single cases, management is often surgical.

Keywords

• Tillaux fracture
• Rare
• Surgical management