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

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2256 VII Imaging of the Musculoskeletal System A B C 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. Ch047-A05375.indd 2256 9/9/2008 5:34:50 PM
47 Ankle and Foot 2257 47 A B C Figure 47-64. Triplane fracture in a 13-year-old who twisted an ankle in a sledding accident. Non–weight-bearing anteroposterior (A) and mortise (B) radiographs. When minimally displaced, the fracture margins can be difficult to see on radiographs. The black arrow points to the epiphysis fracture, running vertically in the sagittal plane (plane 1). The white arrow points to the physis fracture, running horizontally in the axial plane (plane 2). C, Lateral non–weight-bearing radiograph. The arrow points to the physis fracture, running horizontally in the axial plane. The arrowheads point to the metaphysis fracture, running obliquely vertically in the coronal plane (plane 3). Continued Ch047-A05375.indd 2257 9/9/2008 5:34:51 PM
Page 1 and 2: Ken L. Schreibman Richard Bruce Ank
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Ankle and Foot 47 - Department of Radiology - University of ...

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