Avulsion from the tibia (Tillaux-Chaput)

Anatomically reduce the fragment with a small dental hook and preliminarily fix it with a 1.0 mm K-wire.

Drill a hole with a 2.5 mm drill bit and protection sleeve as perpendicular as possible to the fracture line without drilling the far cortex.

Measure the depth. Tap the fragment with the 4.0 mm tap and protection sleeve. Insert the 4.0 mm cancellous screw with a washer.


If the fragment is too small for 4.0 mm screw fixation, use a 2.7 mm or a 2.0 mm cortex screw, or suture the fragment to the periosteum of the anterior tibia.


Avulsion from the fibula (Le Fort lesion or Wagstaff fragment)

Usually, the fragment is very small. In this case suture it to the fibular periosteum. If the fragment is large enough, small lag screw fixation can be used.