Earlier fracture union and earlier weight-bearing: arthroscopy-assisted versus open reduction with percutaneous K-wire fixation for juvenile Tillaux fractures.

OBJECTIVE: To compare arthroscopy-assisted closed reduction with percutaneous K-wire fixation (AS) versus open reduction with percutaneous K-wire fixation (OR) for juvenile Tillaux fractures METHODS: We retrospectively reviewed 22 adolescents with displaced Tillaux fractures treated at our institution between 2017 and 2021 (AS, n=8; OR, n=14). Operative time, time to radiographic union, time to full weight-bearing, and American Orthopaedic Foot & Ankle Society (AOFAS) ankle–hindfoot scores at 3 and 6 months were compared. RESULTS: Baseline demographics and preoperative displacement were comparable between groups. Operative time was longer in the AS group. The AS group had shorter time to radiographic union and earlier progression to full weight-bearing, and higher AOFAS scores at 3 months; by 6 months, AOFAS scores were similarly excellent in both groups. No major complications were observed in either group. CONCLUSION: In this small retrospective cohort, arthroscopy-assisted reduction was associated with earlier radiographic union and earlier weight-bearing compared with open reduction using the same fixation method, with similarly excellent mid-term functional outcomes. Larger prospective studies with pediatric-validated outcome measures and longer follow-up are warranted.