Triplane Fracture: An Intricate Pediatric Injury

Antonios G Angoules

doi:10.4172/2165-7548.1000e142

Abstract

The specific fracture pattern of these unusual intra-articular lesions of the distal tibia, which are combinations of Salter- Harris types II, III, and IV, is characterized by fracture lines which extend into three anatomic planes. More specifically the sagittal fracture extends through the epiphysis, whilst the coronal component occurs through the posterior tibial metaphysis, and the transverse fracture imperils the growth plate [2,7]. Given their complexity, the exact fracture pattern of these multiplanar injuries cannot always be easily identified based on standard anteroposterior, medial-lateral and mortise plain radiographs [8] so often added investigation with two or three-dimensional imaging is mandatory [2]. Advanced radiography imaging and more specifically Computerized Tomography (CT) is a useful tool which depicts the fracture configuration in multiple planes. The disclosure of articular damage in a detailed analysis, as well as the depiction of the number and special anatomical characteristics of the displaced fragments, highlights the valuable contribution of this imaging modality for the diagnosis and treatment of triplane fractures [9-11].

Highlights

Conservative treatment is the treatment of choice on the assumption of a nondisplaced fracture occurrence
It includes the application of a short or long leg plaster cast or 4 to 8 weeks followed by gradual weight-bearing [1,8,12]
When closed reduction is needed this is achieved under general anesthesia, using intensified imaging, with adduction for medial triplane fractures and internal rotation for lateral triplane fractures respectively [13]

Summary

Introduction

Conservative treatment is the treatment of choice on the assumption of a nondisplaced fracture occurrence. It includes the application of a short or long leg plaster cast or 4 to 8 weeks followed by gradual weight-bearing [1,8,12].

Results

Conclusion