• 1

    Goldberg VM, Aadalen R: Distal tibial epiphyseal injuries: the role of athletics in fifty-three cases. .Am J Sports Med 6::263. ,1978. .

  • 2

    Herring MD: “General Principles of Managing Orthopaedic Injuries,” in Tachdjian’s Pediatric Orthopaedics, 4th Ed, Vol 3, ed by MD Herring, p 2355, Saunders, Philadelphia. ,2008. .

    • Crossref
    • Export Citation
  • 3

    Schlesinger I, Wedge JH: Percutaneous reduction and fixation of displaced juvenile Tillaux fractures: a new surgical technique. .J Pediatr Orthop 13::389. ,1993. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4

    Manderson EL, Ollivierre CO: Closed anatomic reduction of a juvenile tillaux fracture by dorsiflexion of the ankle. A case report. .Clin Orthop Relat Res 276::262. ,1992. .

    • Search Google Scholar
    • Export Citation
  • 5

    Miller MD: Arthroscopically assisted reduction and fixation of an adult Tillaux fracture of the ankle. .Arthroscopy 13::117. ,1997. .

  • 6

    Leetun DT, Ireland ML: Arthroscopically assisted reduction and fixation of a juvenile Tillaux fracture. .Arthroscopy 18::427. ,2002. .

  • 7

    Panagopoulos A, van Niekerk L: Arthroscopic assisted reduction and fixation of a juvenile Tillaux fracture. .Knee Surg Sports Traumatol Arthrosc 15::415. ,2007. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8

    Thaunat M, Billot N, Bauer T, et al: Arthroscopic treatment of a juvenile tillaux fracture. .Knee Surg Sports Traumatol Arthrosc 15::286. ,2007. .

  • 9

    Jennings MM, Lagaay P, Schuberth JM: Arthroscopic assisted fixation of juvenile intra-articular epiphyseal ankle fractures. .J Foot Ankle Surg 46::376. ,2007. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10

    Visser JD, Rietberg M: Interposition of the tendon of the long head of biceps in fracture separation of the proximal humeral epiphysis. .Neth J Surg 32::12. ,1980. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11

    Grace DL: Irreducible fracture-separations of the distal tibial epiphysis. .J Bone Joint Surg Br 65::160. ,1983. .

  • 12

    Wood KB, Bradley JP, Ward WT: Pes anserinus interposition in a proximal tibial physeal fracture. A case report. .Clin Orthop Relat Res 264::239. ,1991. .

    • Search Google Scholar
    • Export Citation
  • 13

    Faraj AA, Kumar MS, Ketzer B, et al: An irreducible Salter-Harris type IV distal ulna fracture. .Injury 31::746. ,2000. .

  • 14

    Beslikas TA, Dadoukis DJ, Nenopoulos SP, et al: A completely displaced Salter-Harris I fracture of the distal radial epiphysis with intact ulna: a case report and review of the literature. .Acta Chir Belg 105::539. ,2005. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15

    Phieffer LS, Meyer RA Jr, Gruber HE, et al: Effect of interposed periosteum in an animal physeal fracture model. .Clin Orthop Relat Res 376::15. ,2000. .

    • Search Google Scholar
    • Export Citation

Distal Tibial Epiphyseal Fracture (Tillaux) and Capsular Interposition

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  • 1 Department of Orthopedic and Traumatology, Goztepe Research and Training Hospital, Istanbul, Turkey.
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Arthroscopic-assisted reduction is one recommended technique for pediatric distal tibial epiphyseal fractures. A 15-year-old male patient with a triplane distal tibial epiphyseal fracture (Tillaux type) was scheduled for arthroscopic reduction and pinning, which failed to provide adequate fracture reduction. Open surgery was subsequently performed, which revealed a capsular interposition in the fracture line attributable to an anterior capsular tear of the ankle. The possibility of capsular interposition should always be taken into consideration when problems such as those described in this case presentation are encountered in such patients. This is precisely why direct visualization either through arthroscopy or open arthrotomy is sometimes necessary. (J Am Podiatr Med Assoc 99(5): 435–437, 2009)

Corresponding author: Koray Unay, MD, Department of Orthopedic and Traumatology, Goztepe Research and Training Hospital, Goztepe, Kadikoy, Istanbul, 34349 Turkey. (E-mail: kunay69@yahoo.com)