Ankle and Foot 47 - Department of Radiology - University of ...

2256 VII Imaging of the Musculoskeletal System
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Figure 47-63. Juvenile Tillaux fracture in a 13-year-old who reported hearing or feeling a snap when, during cheerleading, she landed very
forcefully on the left foot with the ankle twisted. A Salter-Harris type 3 fracture was seen on outside radiographs (not shown). A CT series was
requested to assess the degree of fracture displacement. A, Axial CT image through both distal tibial physes demonstrates the avulsion fracture of
the left anterolateral quadrant (sad face). B, Coronal CT image shows the Salter-Harris type 3 fracture with a longitudinal component through the
epiphysis (arrow) and a transverse component through the unfused lateral physis (white arrowheads). The fused medial physis is indicated by the
black arrowheads. C, Sagittal CT image shows the Salter-Harris type 3 fracture with a longitudinal component through the epiphysis (arrow) and a
transverse component through the unfused physis (arrowheads). Because CT showed that the fracture fragments were displaced more than 2 mm,
open reduction and internal fixation was performed electively 1 week after the injury. Postoperatively the patient did well after being non–weight
bearing in a cast for 6 weeks and in a weight-bearing boot for 4 weeks.
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9/9/2008 5:34:50 PM