Volkmann and Tillaux Fracture in Adults: An Unusual Bimalleolar Equivalent. A Case Report

Keywords: Tillaux, Chaput, malleolar equivalent, Volkmann, bimaleolar, case report

Abstract

Fractures of the distal anterolateral tibial malleolus, known as Tillaux-Chaput fractures, are common in skeletally immature patients but rare in adults. The posterior lip of the distal tibia, or Volkmann fragment, may present as an isolated fracture but is more commonly associated with trimalleolar or quadrimalleolar fracture-dislocations, as well as Maisonneuve-type injuries. However, the simultaneous occurrence of Volkmann-Tillaux fractures is extremely rare and has been scarcely reported in the literature. We present a case of a bimalleolar equivalent fracture in an adult, discussing its diagnosis, classification, management, and clinicalradiological outcome.

Downloads

Download data is not yet available.

Author Biographies

Juan Manuel Romero Ante, Orthopedics and Traumatology Service, Foot and Ankle Surgery, Clínica Antioquia, Itagüí, Colombia
Orthopedics and Traumatology Service, Foot and Ankle Surgery, Clínica Antioquia, Itagüí, Colombia
Juan Gabriel Jaramillo, Orthopedics and Traumatology Service, Foot and Ankle Surgery, Clínica Antioquia, Itagüí, Colombia
Orthopedics and Traumatology Service, Foot and Ankle Surgery, Clínica Antioquia, Itagüí, Colombia

References

Hermans JJ, Beumer A, de Jong TA, Kleinrensink GJ. Anatomy of the distal tibiofibular syndesmosis in adults: a

pictorial essay with a multimodality approach. J Anat 2010;217(6):633-45. https://doi.org/10.1111/j.1469-7580.2010.01302.x

Yuen CP, Lui TH. Distal tibiofibular syndesmosis: Anatomy, biomechanics, injury and management. Open Orthop J 2017;11:670-7. https://doi.org/10.2174/1874325001711010670

Rammelt S, Bartoníček J, Kroker L, Neumann AP: Surgical fixation of quadrimalleolar fractures of the ankle. J

Orthop Trauma 2021;35(6):e216-e222. https://doi.org/10.1097/BOT.0000000000001915

Akoh CC, Phisitkul P. Anatomic ligament repairs of syndesmotic injuries. Orthop Clin North Am 2019;50(3):401-4. https://doi.org/10.1016/j.ocl.2019.02.004

Giacobazzi M, Gologram M, Mitchell R, Kasik C, Gonzalez NM. A Tillaux fracture and concurrent nondisplaced

Salter-Harris type III fracture of the distal fibula: A case report. Cureus 2023;15(5):e39651. https://doi.org/10.7759/cureus.39651

Millán-Billi A, Fa-Binefa M, Gómez-Masdeu M, Carrera I, De Caso J. Tillaux fracture in adults - case report and

review of literature. J Clin Orthop Trauma 2022;27:101809. https://doi.org/10.1016/j.jcot.2022.101809

Tomar L, Govil G, Dhawan P. Isolated posterior malleolar fracture: A case report of a rare presentation with

narrative review of literature. Cureus 2022;14(1):e21658. https://doi.org/10.7759/cureus.21658

Haapamaki VV, Kiuru MJ, Koskinen SK. Ankle and foot injuries: analysis of MDCT findings. AJR Am J Roentgenol

;183(3):615-22. https://doi.org/10.2214/ajr.183.3.1830615

Rammelt S, Bartoníček J, Schepers T, Kroker L. Fixation of anterolateral distal tibial fractures: the anterior malleolus. Oper Orthop Traumatol 2021;33(2):125-38. https://doi.org/10.1007/s00064-021-00703-0

Bartoníček J, Rammelt S, Kostlivý K, Václav Vanecek, Klika D, Tresl I. Anatomy and classification of the posterior tibial fragment in ankle fractures. Arch Orthop Trauma Surg 2015;135(4):505-16. https://doi.org/10.1007/s00402-015-2171-4

Nicolai C, Bierry G, Faruch-Bilfeld M, Sans N, Willaume T. The concept of ring of injuries: evaluation in ankle

trauma. Skeletal Radiol 2022;51(10):2027-37. https://doi.org/10.1007/s00256-022-04062-0

Bae KJ, Kang SB, Kim J, Lee J, Go TW. Reduction and fixation of anterior inferior tibiofibular ligament avulsion fracture without syndesmotic screw fixation in rotational ankle fracture. J Int Med Res 2020;48(4):300060519882550. https://doi.org/10.1177/0300060519882550

Kose O, Yuksel HY, Guler F, Ege T. Isolated adult Tillaux fracture associated with Volkmann fracture - a unique

combination of injuries: Report of two cases and review of the literature. J Foot Ankle Surg 2016;55(5):1057-62.

https://doi.org/10.1053/j.jfas.2015.10.005

Mansur H, Lima T, Goncalves C, Castro I. Adult Tillaux fracture in association with Volkmann and Maisonneuve

fractures: A case report. Revista Colombiana de Ortopedia y Traumatología 2019;33(3-4):133-7.

https://doi.org/10.1016/j.rccot.2020.02.004

Pérez Motos S, Morales Rodríguez J, García Álvarez J, Martínez López D, Rodrigo Pérez JL. Fractura de Tillaux

asociada a fractura de Volkmann, un caso excepcional en el adulto. 48° Congreso SOTOCAV, Xàtiva, 2021.

Disponible en: www.sotocav2.es/congresos/2021/Posters/P-44.pdf

Rammelt S, Bartoníček J, Kroker L. Pathoanatomy of the anterolateral tibial fragment in ankle fractures. J Bone

Joint Surg Am 2022;104(4):353-63. https://doi.org/10.2106/JBJS.21.00167

Published
2025-04-30
How to Cite
Romero Ante, J. M., & Jaramillo, J. G. (2025). Volkmann and Tillaux Fracture in Adults: An Unusual Bimalleolar Equivalent. A Case Report. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 90(2), 190-196. https://doi.org/10.15417/issn.1852-7434.2025.90.2.2081
Section
Case Presentations