Triplane Ankle Fracture
Triplane Fx ICD-9
- 824.8 (closed; unspecified ankle fracture)
- 824.9 (open; unspecified ankle fracture)
- 823.80 (unspecifiecd part, closed, tibia alone)
- 823.90 (unspecified part, open, Tibia alone)
- 823.82(unspecifiecd part, closed, fibula with tibia)
- 823.92 (unspecified part, open, fibula with Tibia)
Triplane Fx Etiology / Epidemiology / Natural History
- A form of transitional ankle fracture related to the asymmetric pattern of distal tibial physeal closure.
- Thought to be caused by external rotation forces.
Triplane Fx Anatomy
- Distal tibial growth plate closure starts anteromedially, progresses posteriorly and laterally and finishes anterolaterally.
Triplane Fx Clinical Evaluation
- Pain and deformity in the ankle, degree dependent on fracture severity.
- Evaluate skin integrity, swelling, and neurovascular status of the leg/foot.
Triplane Fx Xray / Diagnositc Tests
- A/P, lateral and mortise views of the ankle. Appears like a Salter-Harris III fx on the A/P view, but like a Salter-Harris II fx on the lateral view.
- CT often helpful to determine fracture configuration. (Jones S, Injury 2003;34:293).
- MRI generally not indicated although can provide information on ligamentous and physeal injury. (Lohman M, Skeletal Tadiol 2001;30:504).
Triplane Fx Classification / Treatment
- Nondisplaced: immobilization
- Displaced (>2mm): open or closed reduction and fixation with cannulated screws
Triplane Fx Associated Injuries / Differential Diagnosis
Triplane Fx Complications
- Delayed union, nonunion
- Growth arrest
- Osteonecrosis of the distal tibial epiphysis
- Compartment syndrome
Triplane Fx Follow-up Care
Triplane Fx Review References