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Distal Tibial Epiphyseal Fracture (Tillaux) and Capsular Interposition

Oguz Poyanli Department of Orthopedic and Traumatology, Goztepe Research and Training Hospital, Istanbul, Turkey.

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Koray Unay Department of Orthopedic and Traumatology, Goztepe Research and Training Hospital, Istanbul, Turkey.

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Kaya Akan Department of Orthopedic and Traumatology, Goztepe Research and Training Hospital, Istanbul, Turkey.

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Korhan Ozkan Department of Orthopedic and Traumatology, Goztepe Research and Training Hospital, Istanbul, Turkey.

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Ender Ugutmen 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)
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