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Predictive Factors for Tillaux-Chaput Tubercle Fracture: A Case-Control Study
Cédric Dongmo Mayopa1,2,3, David Ancelin4, Pauline Despontin2
1UCLouvain-IREC, Neuromusculoskeletal Lab (NMSK), Brussels, Belgium.
Background:
Tillaux-Chaput tubercle fractures in adults often go unnoticed on standard radiographs in the setting of other malleolar fractures. This study aimed to identify clinical and radiologic factors associated with these fractures to develop a decision aid for computed tomographic (CT) diagnosis.
Methods:
This case-control study included 72 patients with bimalleolar fractures who underwent both radiography and CT scans. The case group consisted of 28 patients with Tillaux-Chaput fractures, and 44 served as control. Sociodemographic, clinical data, and injury mechanisms were compared using univariate and multivariate analysis to identify predictive factors.
Results:
Tillaux-Chaput fractures were undetected on standard radiographs in 60% of cases. In multivariate analysis, only age >60 years and injury mechanisms with Lauge-Hansen pronation-external rotation stage III or IV injuries were found to be highly associated with Tillaux-Chaput tubercle fractures.
Conclusion:
We recommend routine CT scan evaluation for patients >60 years old with stage III or IV pronation-external rotation ankle fractures.
Level Of Evidence:
Level III, case-control study.
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