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

2258 VII Imaging of the Musculoskeletal System
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Figure 47-64, cont’d D to F, CT scanning was performed after closed reduction and casting to assess the degree of fracture displacement.
D, Axial CT scan. The avulsion fracture of the anterolateral quadrant (sad face) resembles the juvenile Tillaux fracture (see Fig. 47-63A). The
surrounding plaster cast causes no streak artifacts and helps to immobilize the patient’s ankle during scanning. E, Coronal CT scan. 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). F, Sagittal CT scan. The arrow points to the physis fracture, running horizontally in the axial plane (plane
2). The arrowheads point to the metaphysis fracture, running obliquely vertically in the coronal plane (plane 3). These images clearly showed the
surgeons that the closed reduction still had unacceptable displacement, and open reduction and internal fixation was performed the next day.
After surgery, the patient was non–weight bearing in a cast for 4 weeks and was pain free after 1 week in a walking boot.
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9/9/2008 5:34:53 PM