title: Triplane fractures of the distal tibia in children.
abstract: OBJECTIVE
  To review 28 cases of paediatric triplane fractures of the distal tibia over a 7-year period in a tertiary paediatric hospital.
  
  
  METHODS
  Records of 21 boys and 7 girls aged 11 to 15 (mean, 13) years presented with triplane fractures of the left (n=14) and right (n=14) ankles were retrospectively reviewed.
  
  
  RESULTS
  Injury mechanism included low-energy trauma (n=10) and moderate-energy trauma (n=18). Fractures were 2-part in 20 patients, 3-part in 6, and 4-part in 2. 11 patients had concomitant fibular fractures. Articular displacement was <2 mm in 17 patients and ≥2 mm in 11 patients. 17 patients were treated conservatively (cast immobilisation); 11 were treated surgically by closed reduction and percutaneous pinning (n=1), open reduction and percutaneous pinning (n=5), closed reduction and internal fixation (n=3), or open reduction and internal fixation (n=2). Transepiphyseal partially threaded cannulated screws were used for fixation. The mean period of casting was 5.8 weeks, and the mean non- weight bearing period was 6.1 weeks. The mean follow-up period was 14.2 (range, 9-20) weeks. All patients had excellent outcome. No patient had any infections, delayed or non-union. Six patients had decreased range of motion and 4 had pain 4 weeks after cast removal.
  
  
  CONCLUSIONS
  Treatment outcome of triplane fractures of the distal tibia in children is good when guidelines are closely adhered to.
authors: Department of Orthopaedics, KK Women's and Children's Hospital, Singapore. adrian_tan@mac.com
authors: Adrian Chong Beng
authors: AC
authors: Tan
authors: Roland Weng Wah
authors: RW
authors: Chong
authors: Arjandas
authors: A
authors: Mahadev
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D013978:Tibial Fractures / Q000628:therapy*
keywords: adolescent; ankle injuries; ankle joint; fibula; talus; tibia; treatment outcome