Tillaux 骨折是累及胫骨远端骨骺的关节内骨折，约占所有胫骨远端骨骺损伤的 2.9%。单靠 X 片容易漏诊，一旦误诊或漏诊导致踝关节不匹配、不稳定，患者会遗留疼痛甚至发展为创伤性关节炎。
胫骨远端骨骺闭合的顺序。闭合从前内侧区域 (A) 开始，然后向内侧 (B)、后侧（C）和外侧（D）进行。图源：DOI: 10.1302/2058-5241.6.200042.
图源：DOI: 10.1302/2058-5241.6.200042.
关节镜辅助下复位固定。A（踝关节镜前内侧入路）见到骨折部位移位，影响关节匹配性。B（踝关节镜前内侧入路）使用探钩复位骨折块。C（踝关节镜前外侧入路）确认骨折块复位。D（踝关节镜前外侧入路）在关节镜监视下经皮打入克氏针。图源：DOI: 10.1007/s00167-006-0234-3.
作者：阿 C
图源：文末文献
参考文献
1、Cancino B, Sepúlveda M, Birrer E. Ankle fractures in children. EFORT Open Rev. 2021 Jul 8;6(7):593-606. doi: 10.1302/2058-5241.6.200042. PMID: 34377551; PMCID: PMC8335959.
2、Habusta SF, Ponnarasu S, Mabrouk A, Griffin EE. Tillaux Fracture. 2022 Feb 7. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan–. PMID: 29493957.
3、Denning JR, Gohel S, Arkader A. Open Reduction and Internal Screw Fixation of Transitional Ankle Fractures in Adolescents. JBJS Essent Surg Tech. 2021 Dec 22;11(4):e19.00070. doi: 10.2106/JBJS.ST.19.00070. PMID: 35685651; PMCID: PMC9173518.
4、Choudhry IK, Wall EJ, Eismann EA, Crawford AH, Wilson L. Functional outcome analysis of triplane and tillaux fractures after closed reduction and percutaneous fixation. J Pediatr Orthop. 2014 Mar;34(2):139-43. doi: 10.1097/BPO.0000000000000085. PMID: 24172672.
5、Thaunat M, Billot N, Bauer T, Hardy P. Arthroscopic treatment of a juvenile tillaux fracture. Knee Surg Sports Traumatol Arthrosc. 2007 Mar;15(3):286-8. doi: 10.1007/s00167-006-0234-3. Epub 2006 Dec 6. PMID: 17149643.
6、Crawford AH. Triplane and Tillaux fractures: is a 2 mm residual gap acceptable? J Pediatr Orthop. 2012 Jun;32 Suppl 1:S69-73. doi: 10.1097/BPO.0b013e31824b25a1. PMID: 22588107.
