Analysis of 51 tibial triplane fractures using CT with multiplanar reconstruction.
OBJECTIVE
We determined the most common patterns of triplane fractures and assessed the risk of epiphyseal separation in each pattern.


METHODS
Fifty-one children with tibial triplane fractures underwent CT, and the resultant scans underwent multiplanar reconstruction. We categorized epiphyseal and physeal involvement, the number of fragments, the appearance of the Salter-Harris fracture in each plane, and the degree of separation of the epiphyseal fragments.


RESULTS
The classic two-fragment type of fracture with medial epiphyseal extension occurred most frequently (33/51). All three-fragment types (8/51) of fractures resulted in a separate anterolateral fragment. Extension to the medial malleolus was common (12/51). None of the four reported fractures types involving anteromedial physeal separation was seen. Children with epiphyseal separation requiring surgery were older (odds ratio [OR] = 1.7) and had plafond involvement (OR = 5),


CONCLUSIONS
CT and multiplanar reconstruction of triplane fractures improve the understanding of patterns of injury and their relative prevalence.
Brown
Stephen D
SD
Department of Radiology, Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA. Stephen.brown@tch.harvard.edu
Kasser
James R
JR
Zurakowski
David
D
Jaramillo
Diego
D
D000293:Adolescent; D016512:Ankle Injuries / Q000000981:diagnostic imaging*; D002648:Child; D004838:Epiphyses / Q000293:injuries; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D013978:Tibial Fractures / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed