J Korean Foot Ankle Soc.  2024 Sep;28(3):111-113. 10.14193/jkfas.2024.28.3.111.

Surgical Treatment of Maisonneuve Fracture Accompanied by Tillaux-Like Fracture: A Case Report

• Kim GL
• Lee SJ
• Cho JH

• KMID: 2559641
• DOI: http://doi.org/10.14193/jkfas.2024.28.3.111

Abstract

Tillaux fractures, a rare type corresponding to Salter–Harris type 3, are observed in approximately 3% of pediatric ankle fractures. They are known to occur primarily via a supination–external rotation mechanism. Maisonneuve fractures, on the other hand, are proximal fibula fractures involving injury on syndesmosis, deltoid ligament, or medial malleolus fracture, occurring via a pronation-external rotation mechanism. These two types of fractures occur through different mechanisms of injury. In this study, a nine-year-old female pediatric patient presented to the outpatient department with ankle pain following a fall from a trampoline and was diagnosed with concurrent Tillaux-like fracture and Maisonneuve fractures. Surgical treatment was performed, resulting in successful recovery.

Keyword

Tillaux fracture; Maisonneuve fracture; Salter–Harris fracture

Figure

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  Figure 1 (A) Salter–Harris type 3 fracture on the anteroposterior (AP) view of the ankle radiograph. (B) Maisonneuve fracture on the AP view of lower leg radiograph.

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  Figure 2 (A) Magnetic resonance imaging reveals a fracture confined to the epiphysis and physis, not extending into the metaphysis. (B) Distal tibia avulsion fracture of periosteum can be identified by the periosteum separated on the lateral side compared to the medial side. (C) The fracture line is extended to the posterior aspect. (D, E) Computed tomography reveals reveals a fracture confined to the epiphysis and physis, not extending into the metaphysis.

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  Figure 3 The incision was made on lateral side.

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  Figure 4 (A) Reduction was performed by freer elevator. (B) Maintaining fixation with reduction clamp, the cannulated screw fixation was done, ensuring that the screw did not penetrate the physis.

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  Figure 5 Bone union is confirmed at the third month post-surgery.

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