Abstract
PurposeWe aimed to analyze the clinical and functional outcomes of patients who underwent surgery or received conservative treatment to look into the impact of treatment methods on clinical outcomes.MethodsA retrospective study was performed on 25 patients with a minimum one-year follow-up. Patients were divided into two groups based on joint and physis displacement measured on preop CT images. Patients with a displacement of > 2 mm underwent surgery, while those with a displacement of < 2 mm received conservative treatment. The clinical results were assessed using the Ankle-Hindfoot Scale developed by the American Orthopedic Foot and Ankle Society (AOFAS) and the Modified Weber Protocol (MWP).ResultsThe sample consisted of 14 patients who underwent surgery and 11 patients who received conservative treatment. The surgical group had a mean follow-up of 36.79±14.43 months, while the conservative group had a mean follow-up of 31.82±13.55 months. The surgical and conservative groups had a postop 1st-year AOFAS score of 96.64±3.54 and 93.64 ± 4.69, respectively. The difference was statistically insignificant (p > 0.05), but the surgical group had higher scores numerically. The surgical and conservative groups had a postop 6th-month AOFAS score of 84.64±1.64 and 80.82±2.85, respectively. The difference was statistically significant (p < 0.05).ConclusionThe results of both surgical treatment and conservative treatment are satisfactory. Especially, surgical treatment should not be avoided in patients requiring surgery with a displacement of more than 2 mm and surgeons may consider surgery for better clinical outcomes and earlier rehabilitation in the treatment of triplane fractures.
Highlights
Pediatric distal tibia triplane fractures are ankle injuries that affect skeletally immature children and account for 5% to 7% of all ankle fractures in that patient group [1]
The sample consisted of 14 patients who underwent surgery and 11 patients who received conservative treatment
The surgical group had a mean follow-up of 36.79±14.43 months, while the conservative group had a mean follow-up of 31.82±13.55 months
Summary
Pediatric distal tibia triplane fractures are ankle injuries that affect skeletally immature children and account for 5% to 7% of all ankle fractures in that patient group [1]. Traumas in the pediatric age group are important because they affect the joint surface and pass through the growth cartilage [5,6]. Physicians need more than standard anteroposterior (AP) and lateral radiography (LR) to diagnose triplane fractures and make surgical decisions [8]. There is still no consensus on surgical indication decisions for triplane fractures in the pediatric age group. Treatment decisions depend on the extent of displacement of the distal articular fracture, the displacement of the physis, or the presence of intra-articular displaced bodies. In case of a displacement of more than 2 mm on the articular surface, the rule of thumb is the necessity of anatomical reduction, but this
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