Osteosynthesis of a triplane fracture under arthroscopic control in a bilateral case

Abstract

There are various types of ankle triplane fractures; they may be lateral and medial with two, three or four fragments. Some are described as extra-articular. We describe an exceptional bilateral case occurring after a trampoline accident of a displaced articular and an extra-articular fracture. The extra-articular fracture was treated by closed reduction and percutaneous fixation under fluoroscopic control. For the displaced articular fracture, an arthroscopically assisted reduction and percutaneous fixation was performed. The degree of rotation of the antero-lateral fragment of the articular triplane fracture, during percutaneous screw fixation, was not visible under image intensifier but could be corrected under arthroscopic control. Several portals can be made to enhance articular fracture reduction. This surgical procedure offers reliability and safety to the reduction and the synthesis of this articular fracture. It allows surgery to be less invasive in young patients, while decreasing the risk of malunion and poor long-term clinical results.