Letts R M
J Pediatr Orthop. 1982 Jun;2(2):161-4. doi: 10.1097/01241398-198202020-00007.
Ankle injuries are common in adolescence, seldom initially seen by orthopaedists, and often treated primarily by emergency department personnel. It is often not appreciated that the distal tibial growth plate fuses in a mediolateral direction, leaving it open and vulnerable to growth plate injuries for a longer period during adolescence. Fractures of the lateral plafond of the tibia are often not appreciated due to overlap of the fibula. A review of the injuries at the Winnipeg Children's Hospital has revealed these are not as uncommon as often supposed. A 3 year experience yielded 26 patients with so-called "Tillaux fractures" of which 9 could be diagnosed only by the oblique view and 5 were initially missed. Knowledge of the anatomical behavior of the fusing tibial growth plate in the ankle-injured adolescent plus mandatory oblique views of the ankle in this age group should enable the casualty officer in a busy emergency department to bring this fracture out of hiding and make the diagnosis in every instance.
踝关节损伤在青少年中很常见，最初很少由骨科医生诊治，通常主要由急诊科人员进行治疗。人们常常没有认识到，胫骨远端生长板是从内侧向外侧融合的，这使得它在青少年时期开放的时间更长，更容易受到生长板损伤。由于腓骨的重叠，胫骨外侧平台骨折常常不易被发现。对温尼伯儿童医院的损伤情况进行回顾发现，这些损伤并不像人们通常认为的那样罕见。一项为期3年的研究发现了26例所谓的“蒂洛骨折”患者，其中9例只能通过斜位片诊断出来，5例最初被漏诊。了解踝关节受伤青少年中融合的胫骨生长板的解剖学特点，以及对该年龄组踝关节进行必要的斜位片检查，应该能使繁忙急诊科的急救人员发现这种骨折并在每种情况下都能做出诊断。
