Ankle fractures in children and adolescents cover different patterns: distal tibial and fibular physeal injuries, malleolar fractures and joint lesions. In adolescents, as the distal tibial physis is closing, the typical transitional injuries also appear — Tillaux and triplane fractures.
The distal tibial growth plate closes asymmetrically, from the centre outwards, over months. In this window, certain rotational traumas create fractures that cross the physis in characteristic ways. That is how Tillaux and triplane fractures arise.
Reduction (closed or open) and fixation with one or two dedicated screws. Pre-op CT is often used to define exact displacement.
Intra-articular fracture of the anterolateral distal tibia, typical of the adolescent. Displaced forms have a surgical indication.
Reduction and screw fixation, with plate use depending on fracture geometry. Planning often relies on CT.
Complex fracture crossing the physis on multiple planes. Displaced or unstable forms.
Reduction and fixation with screws, wires or staples depending on type (II, III, IV). The choice of fixation aims to minimise additional damage to the growth plate, respecting the physis whenever the fracture geometry allows it.
Displaced, intra-articular or unstable forms, especially with significant risk of growth disturbance.
Depending on displacement: conservative treatment with cast or fixation with screws/wiring.
Significant displacement, instability, joint involvement.
Not on principle, but when it can change the surgical decision:
On the adolescent ankle it is not enough to know there is a fracture: you need to know which fracture. The difference between Tillaux, triplane and classic Salter-Harris changes everything.
Bring the ER report and the X-rays. A focused paediatric orthopaedic visit can clarify indication, timing and alternatives.
Book a visitContent for general informational purposes only. It does not replace a medical evaluation.