The pediatric triplane ankle fracture.
The pediatric triplane ankle fracture represents a unique spectrum of injury that does not fit neatly into the Salter-Harris classification of physeal injury. This fracture is particular to the pediatric population and often is termed a transitional injury. It is the result of the characteristic asymmetric closure of the distal tibial physis over a period of approximately 18 months. The triplane ankle fracture is a multiplanar injury with three classically described fracture fragments. It has several variations and represents 5% to 10% of pediatric intra-articular ankle injuries. The fracture typically presents in children aged 12 to 15 years; incidence is slightly higher in boys than in girls. Nondisplaced triplane fractures and extra-articular fractures can be managed with immobilization in a long leg cast. Displaced fractures are treated with open reduction and internal fixation performed through an anterolateral approach or an anteromedial approach. Intra-articular reduction to within 2 mm is required for optimal treatment of these unique pediatric ankle fractures.
Schnetzler
Kent A
KA
Woodland Park Orthopaedic Associates, Pikes Peak Regional Hospital, Woodland Park, CO, USA.
Hoernschemeyer
Daniel
D
D016512:Ankle Injuries / Q000175:diagnosis* / Q000601:surgery; D002648:Child; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D013978:Tibial Fractures / Q000175:diagnosis* / Q000601:surgery; D015599:Trauma Severity Indices