A 13-year-old girl presents after injuring her left ankle. A radiographic and CT image are provided. What type of Salter-Harris fracture is this injury?
Pediatric fractures/growth-plate injuries
The juvenile fracture of Tillaux is an isolated fracture of the anterolateral portion of the distal tibia epiphysis (thus a Salter-Harris type III fracture) and accounts for 3% to 5% of pediatric ankle fractures. It occurs when only the lateral physis has yet to fuse. During the injury, an external rotation force is applied to a supinated foot causing the avulsion of the lateral epiphysis fragment by the anterior tibiofibular ligament. The fracture line travels vertically from the articular surface to physis before spreading laterally along the physis.
Bible JE et al. Ankle Fracture in Children and Adolescents. J Chromesthesia. 2009;24:211-219.