Paul Tillaux

Paul Jules Tillaux (1834-1904) was a French Surgeon.

Tillaux performed cadaveric experiments and demonstrated stress applied to the anterior inferior tibiofibular ligament resulted in an avulsion fracture.

Eponymously affiliated with multiple eponyms most notably the Aïe crépitant de Tillaux (1895); Manœuvre de Tillaux; Appareil de Tillaux; the Tillaux fracture; the Spiral of Tillaux; and the Tillaux enucleation “from behind forward

A similar injury to the anterolateral tibia cadeveric description by Tillaux (1872) was later described by Henri Chaput in 1907 hence the term the Tillaux-Chaput fracture.


Biography
  • Born on December, 8 1834 in Aulnay-sur-Odon, Calvados
  • 1857 – Interne des Hôpitaux
  • 1862 – Doctor of medicine, Paris. Theses: ‘Des conduits excréteurs des glandes sublinguale et lacrymale‘ [Excretory ducts of the sublingual and lacrimal glands
  • 1863 – Surgeon to the Bureau Central
  • 1866 – Professeur-Agrégé of Surgery, in Paris and defended his aggregation entitled: Des Affections chirurgicales des Nerfs
  • 1868 – Director of the Amphitheatre d’Anatomie des Hopitaux de Paris
  • 1878 – Surgeon to the Beaujon Hospital
  • 1890 – Professor of Clinical Surgery at the Hôpital de la Charité
  • 1900 – Hon FRCS at the Royal College of Surgeons, England
  • 1904 – President of the Académie de Médecine
  • Died on October 20, 1904

Medical Eponyms
Tillaux fracture (1872) [Tillaux-Chaput fracture]

Fracture of the anterolateral tibial epiphysis commonly seen in adolescents. (Salter-Harris III tibial fracture)

Usually associated with forced lateral rotation of the foot or medial rotation of the leg on a fixed foot. This rotational injury results in avulsion of the anterior tibiofibular ligament at the lateral epiphysis. Often misdiagnosed as a simple sprain in adolescents.

Best seen on conventional AP, lateral, and mortise ankle XR. However, CT scan has better sensitivity in diagnosing Tillaux fractures and used to detect fracture displacement of >2mm – often an indication for open reduction

Tillaux fracture salter harris III
Tillaux fracture. Intra-articular fracture of the anterolateral aspect of the distal tibial epiphysis

Orthopaedic eponyms

Tillaux manoeuvre (Manœuvre de Tillaux) – clinical examination of the breast: to demonstrate the adhesion of a breast tumor to pectoralis major. The mobility of the tumor within the deep planes is reduced when pectoralis major is contracted, by opposing adduction of patients arm.

Tillaux painful crepitus sign (Aïe crépitant de Tillaux) – described tenosynovitis of the adductor and the short extensor of the thumb in 1893 (ahead of de Quervain (1895)

Tillaux apparatus (Appareil de Tillaux) – used to reduce and maintain femoral diaphysis fractures in constant steady extension. The device was made up of strips of diachylon, glued to the outer and inner sides of the leg, forming a stirrup under the foot. To this stirrup, the traction cord was attached.

Appareil de Tillaux 1910
Appareil de Tillaux. Gazette des hôpitaux civils et militaires. 1910

Other eponyms

Spiral of Tillaux: an imaginary line connecting the insertions of the recti muscles of the eye in relation to the limbus.

Conventional teaching states that the spiral of Tillaux marks the location of the ora serrata. On literature review, no source for this was found.

Anatomic relationship of the ora serrata to the spiral of Tillaux
Anatomic relationship of the ora serrata to the spiral of Tillaux. White et al 1989

Tillaux enucleation from behind forward

Tillaux introduced his own modified technique for the enucleation of the eye

Diviser la conjonctive et le fascia sous-conjonctival avec des ciseaux courbes, au niveau de l’attache à la sclérotique du muscle droit externe ; diviser le tendon de ce muscle et porter immédiatement les ciseaux par la boutonnière conjonctivale jusque sur le nerf optique; diviser ce nerf à son entrée dans le globe oculaire; saisir le pôle postérieur du globe avec une pince à griffes et l’attirer en dehors à travers la boutonnière conjonctivale, achever ensuite l’opération, en rasant la sclérotique.

Ce mode d’extraction s’opère avec une grande rapidité. Plus que les autres procédés, il diminue les chances d’ouverture de la loge postérieure de l’orbite.

Lefert P, 1895

Divide the conjunctiva and subconjunctival fascia with curved scissors, at the level of the attachment to the sclera of the external rectus muscle; divide the tendon of this muscle and immediately bring the scissors through the conjunctival buttonhole to the optic nerve; divide this nerve as it enters the eyeball; grasp the posterior pole of the globe with clawed forceps and draw it out through the conjunctival buttonhole, then complete the operation, shaving off the sclera.

This mode of extraction takes place with great rapidity. More than the other processes, it decreases the chances of opening the posterior compartment of the orbit.

Lefert P, 1895


Major Publications

References

Biography

Eponymous terms (orthopaedic)

Eponymous terms (ophthalmology)


Cite this article as: Mike Cadogan and Josh Howard, "Paul Tillaux," In: LITFL - Life in the FastLane, Accessed on August 13, 2022, https://litfl.com/paul-jules-tillaux/.

eponym

the person behind the name

Associate Professor Curtin Medical School, Curtin University. Emergency physician MA (Oxon) MBChB (Edin) FACEM FFSEM Sir Charles Gairdner Hospital.  Passion for rugby; medical history; medical education; and asynchronous learning #FOAMed evangelist. Co-founder and CTO of Life in the Fast lane | Eponyms | Books | Twitter |

Dr Josh Howard - wannabe future orthopod, finding myself in Australia | LinkedIn

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