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Related Experiment Videos

The hidden adolescent ankle fracture.

R M Letts

    Journal of Pediatric Orthopedics
    |June 1, 1982
    PubMed
    Summary

    Adolescent ankle injuries, particularly Tillaux fractures, are often missed. Early diagnosis requires understanding tibial growth plate fusion and using oblique ankle views in the emergency department.

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    Area of Science:

    • Orthopedic Surgery
    • Pediatric Emergency Medicine
    • Adolescent Sports Medicine

    Background:

    • Ankle injuries are frequent in adolescents but often initially managed by emergency department personnel, not orthopedists.
    • The distal tibial growth plate's unique mediolateral fusion pattern leaves it vulnerable to injury during adolescence.
    • Fractures of the lateral tibial plafond can be obscured by the fibula, leading to underdiagnosis.

    Purpose of the Study:

    • To highlight the prevalence of Tillaux fractures in adolescents.
    • To emphasize the diagnostic challenges posed by these injuries in emergency settings.
    • To advocate for improved diagnostic strategies for adolescent ankle fractures.

    Main Methods:

    • Retrospective review of ankle injuries treated at a children's hospital over three years.
    • Analysis of fracture patterns, diagnostic methods, and initial misdiagnoses.
    • Evaluation of the role of specific radiographic views in identifying Tillaux fractures.

    Main Results:

    • Twenty-six patients with Tillaux fractures were identified over a 3-year period.
    • Nine fractures required oblique views for diagnosis, and five were initially missed.
    • The study underscores the frequency of these fractures, which are often underestimated.

    Conclusions:

    • Tillaux fractures are more common in adolescents than typically recognized.
    • Understanding the anatomy of the fusing tibial growth plate is crucial for diagnosis.
    • Mandatory oblique ankle views are essential for emergency department personnel to accurately diagnose these injuries.

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