PMC7210922_01
Initial left ankle X-ray, anterior-posterior view.
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F1
Radiographs in the anterior-posterior (Fig. 1), lateral, and oblique views revealed a Salter-Harris type IV fracture of the distal left tibia involving the posterior tibial metaphysis and the anterolateral aspect of the tibial epiphysis.
Left ankle three-dimensional computed tomography, anterior-posterior view showing the Tillaux-Chaput fracture.
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F2
Tillaux fracture and inadequate evidence on plain radiographs, a computed tomography (CT) scan of the left ankle without intravenous contrast was taken. This study revealed an avulsion fracture of the anterolateral tibial epiphysis that is laterally and anteriorly displaced in addition to the non-displaced fracture of the posterior malleolus involving the metaphysis and extending into the tibial plafond with no significant step-off (Fig. 2and 3).
Left ankle three-dimensionalcomputed tomography, posterior oblique view showing Volkmann fracture.
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F3
Tillaux fracture and inadequate evidence on plain radiographs, a computed tomography (CT) scan of the left ankle without intravenous contrast was taken. This study revealed an avulsion fracture of the anterolateral tibial epiphysis that is laterally and anteriorly displaced in addition to the non-displaced fracture of the posterior malleolus involving the metaphysis and extending into the tibial plafond with no significant step-off (Fig. 2and 3).
Left ankle arthroscopic image before repair.
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F4
The K-wires were removed and measured and two 4 mm cannulated screws were then inserted into the distal tibia and visualized arthroscopically and radiographically (Fig. 4, 5, 6and 7).
Left ankle arthroscopic image showing realignment of fragments after interval placement of screw.
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F5
The K-wires were removed and measured and two 4 mm cannulated screws were then inserted into the distal tibia and visualized arthroscopically and radiographically (Fig. 4, 5, 6and 7).
Anterior-posterior view of intraoperative fluoroscopic image showing interval placement of two screws.
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F6
The K-wires were removed and measured and two 4 mm cannulated screws were then inserted into the distal tibia and visualized arthroscopically and radiographically (Fig. 4, 5, 6and 7).
Lateral view of intraoperative fluoroscopic image showing interval placement of two screws.
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F7
The K-wires were removed and measured and two 4 mm cannulated screws were then inserted into the distal tibia and visualized arthroscopically and radiographically (Fig. 4, 5, 6and 7).
Left ankle anterior-posterior view at 1-year follow-up showing stable screws transfixing distal tibial epiphysis with congruent joint spaces and unremarkable soft tissue.
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F8
Final radiographs (Fig. 8) of the ankle show the fracture healing with no loosening of hardware.