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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.
Foot & Ankle Orthopaedics
|May 5, 2025
Summary
Tillaux-Chaput tubercle fractures are often missed on X-rays. Older adults over 60 with specific ankle fracture types benefit from CT scans for accurate diagnosis.
Area of Science:
- Orthopedic Surgery
- Radiology
- Traumatology
Background:
- Tillaux-Chaput tubercle fractures are frequently missed on standard radiographs, especially when associated with other malleolar fractures.
- This diagnostic challenge necessitates improved methods for identifying these injuries.
Purpose of the Study:
- To identify clinical and radiologic factors predicting Tillaux-Chaput tubercle fractures.
- To develop a decision aid for computed tomographic (CT) diagnosis of these fractures.
Main Methods:
- A case-control study involving 72 patients with bimalleolar fractures who had both radiography and CT scans.
- Comparison of sociodemographic, clinical data, and injury mechanisms between patients with and without Tillaux-Chaput fractures.
Main Results:
- Tillaux-Chaput fractures were missed on initial radiographs in 60% of cases.
- Multivariate analysis identified age over 60 years and Lauge-Hansen pronation-external rotation stages III or IV as significant predictors.
- These factors were highly associated with the presence of Tillaux-Chaput tubercle fractures.
Conclusions:
- Routine CT scan evaluation is recommended for patients over 60 years old presenting with pronation-external rotation ankle fractures (stages III or IV).
- This approach can improve the detection rate of Tillaux-Chaput tubercle fractures in at-risk populations.
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