Clinical study of the triplane distal tibial epiphysial fracture and the juvenile fracture of tillaux.

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Cases of the triplane fracture and the juvenile fracture of Tillaux, which are thought to be rare in the adolescent distal tibial epiphysis, were reported with an emphasis on their diagnosis, treatment and mechanism of injury.Six triplane fractures and 3 juvenile fractures of Tillaux in our hospital were reviewed.The causes of injury were trauma in playing sports and fall down.The ages at injury ranged from 11 to 15 years old.All cases were ascertained by plain radiographs at the time of injury and two cases were examined with CT scan.All cases of Tillaux fractures and four cases of the triplane fracture underwent open reduction and internal fixation and the others were treated with casting after closed or open reduction.This study sugested the following:1) The roentgen stereophotogrammetric analysis i. e. CT scan or tomography provided the recognition of accurate fracture lines.2) Open reduction resulted in better anatomical alignment.3) It was clear from the mechanism of injury, that an external rotation force caused a Tillaux fracture, and that the combination of plantar flexion and strong external rotation produced the triplane fracture to the epiphyseal plate of the ankle at the time of maturity.
西日本整形・災害外科学会の論文