Robichaux-Edwards Lindy, Hays Claire, Olmedo Margaret
Department of Orthopaedics, Louisiana State University Shreveport School of Medicine, Medical Student 1501 Kings Highway, Shreveport, LA 71103, USA.
Associate Clinical Professor of Orthopedics,Louisiana State University Shreveport School of Medicine, University Health Shreveport, 1501 Kings Highway, Shreveport, LA 71103, USA.
J Orthop Case Rep. 2019;9(4):44-47. doi: 10.13107/jocr.2019.v09.i04.1472.
Tillaux-Chaput fractures and Volkmann fractures rarely occur together in adolescent patients despite the common occurrence of ankle injuries in adolescent athletics. This particular injury has not previously been well documented in literature.
This article describes the cooccurrence of these two fracture types in a 16-year-old male who suffered significant blunt trauma during a football game resulting in a loss of consciousness and a severe left ankle injury. History and physical examination necessitated radiographs confirming a Salter-Harris IV fracture of the left distal tibial concerning for a Tillaux-Chaput fracture. Computed tomography scans were taken to confirm the full extent of the injury. These images revealed a fracture of the left distal tibia that involved the posterior tibial metaphysis extending into the tibial plafond with no significant step-off and an avulsion fracture of the anterolateral tibial epiphysis that was laterally and anteriorly displaced.
The fracture was treated surgically with close follow-up and physical therapy. Due to the complexity of this injury, long-term follow-up is indicated to prevent fear of use after injury and monitor appropriate healing to lower the risk of post-traumatic arthritis.
尽管青少年运动员中踝关节损伤很常见，但蒂洛克斯 - 沙普骨折和沃尔克曼骨折在青少年患者中很少同时发生。这种特殊损伤此前在文献中未有充分记载。
本文描述了一名16岁男性同时发生这两种骨折类型的情况，该男性在一场足球比赛中遭受严重钝性创伤，导致意识丧失和严重的左踝关节损伤。病史和体格检查后进行了X光检查，证实左胫骨远端为Salter - Harris IV型骨折，怀疑是蒂洛克斯 - 沙普骨折。进行了计算机断层扫描以确认损伤的全貌。这些图像显示左胫骨远端骨折累及胫骨后干骺端并延伸至胫骨平台，无明显台阶移位，以及胫骨前外侧骨骺撕脱骨折，向外侧和前方移位。
该骨折通过手术治疗，并进行密切随访和物理治疗。由于这种损伤的复杂性，需要长期随访以防止受伤后不敢使用，并监测适当的愈合情况，以降低创伤后关节炎的风险。
