Paediatric orthopaedics: Tillaux fracture: practice question

A Orthopaedics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Orthopaedics · Paediatric orthopaedics: Tillaux fracture

Sample item

A 14-year-old girl twists her ankle. CT shows a vertical split through the anterolateral distal tibial epiphysis, with the medial physis already closed and the metaphysis intact. Which injury is this?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Tillaux fracture (Salter-Harris type III)

In adolescence the distal tibial physis closes first centrally, then medially, leaving the anterolateral portion open and vulnerable to avulsion by the anterior tibiofibular ligament. The result is a Salter-Harris type III fracture, the Tillaux fracture, which needs anatomical reduction because it is intra-articular.

Option by option

  • A. Pilon fracture

    A pilon fracture is a comminuted intra-articular fracture of the tibial plafond from axial load.

  • B. Maisonneuve fracture

    A Maisonneuve injury is a proximal fibular fracture with syndesmotic disruption.

  • C. Tillaux fracture (Salter-Harris type III) (correct)

    Correct. An isolated epiphyseal split in a partly closed physis is the Tillaux fracture.

  • D. Triplane fracture

    A triplane fracture also has a metaphyseal component, giving three planes.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is C, Tillaux fracture (Salter-Harris type III). In adolescence the distal tibial physis closes first centrally, then medially, leaving the anterolateral portion open and vulnerable to avulsion by the anterior tibiofibular ligament.

Why is "Pilon fracture" not the answer?

A pilon fracture is a comminuted intra-articular fracture of the tibial plafond from axial load.

Why is "Maisonneuve fracture" not the answer?

A Maisonneuve injury is a proximal fibular fracture with syndesmotic disruption.

Why is "Triplane fracture" not the answer?

A triplane fracture also has a metaphyseal component, giving three planes.

What concept does this question test?

It tests Paediatric orthopaedics: Tillaux fracture in Orthopaedics. The result is a Salter-Harris type III fracture, the Tillaux fracture, which needs anatomical reduction because it is intra-articular.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Paediatric orthopaedics: Tillaux fracture?

Pair each fracture with its classic complication and nerve injured. Then use the flashcards and the other Orthopaedics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.