Triplane ankle fracture

Case contributed by Dr Hisham Alwakkaa

Presentation

History of football injury.

Patient Data

Age: 14 years
Gender: Male
X-ray

The medial portion of the tibial epiphysis is closed, while the lateral portion is open.

Three components of the triplane fracture are demonstrated:

  • vertical fracture through the epiphysis, best appreciated on AP and oblique views
  • horizontal fracture through the physis, best appreciated on oblique and lateral views
  • oblique fracture through the metaphysis, best appreciated on the lateral view

There is also an associated oblique fracture of the distal fibular shaft, which falsely appeared to be continuous with the oblique fracture of the tibia on the lateral view.

Case Discussion

It is called a triplane fracture because it occurs in three planes (sagittal, axial, coronal). It exclusively affects adolescents at the period when the medial portion of the growth plate is closed, while the lateral portion is still open. Most authors regard it as a type IV Salter-Harris fracture.

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Case information

rID: 55779
Case created: 25th Sep 2017
Last edited: 17th Nov 2017
Inclusion in quiz mode: Included
Institution: Women and children Hospital of Buffalo

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