Surgical Management of a Combined Distal Tibia-Fibula Fracture with an Anteroinferior Tillaux Fragment in Adult: A Rare Case Report

This case report presents the surgical management of a rare combined distal tibia-fibula fracture with an anteroinferior Tillaux fragment in a 36-year-old male following a motorcycle accident. Initial radiographs demonstrated a distal tibial spiral fracture and oblique fibular fracture, while subsequent CT imaging revealed the critical Tillaux fragment. The patient underwent open reduction and internal fixation (ORIF) with a 10-hole recon plate for the fibula, minimally invasive percutaneous plate osteosynthesis (MIPPO) for the tibia, and lag screw fixation for the Tillaux fragment. Postoperative imaging confirmed anatomical reduction and stable fixation. This case highlights the diagnostic importance of CT imaging in complex ankle trauma and demonstrates successful surgical management of this unusual fracture combination. The report contributes to the limited literature on adult Tillaux fractures associated with ipsilateral long bone fractures, emphasizing the need for comprehensive imaging and tailored surgical approaches in such high-energy injuries.