Triplane ankle fracture
History of football injury.
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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.
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.