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  • Title: The pediatric triplane ankle fracture.
    Author: Schnetzler KA, Hoernschemeyer D.
    Journal: J Am Acad Orthop Surg; 2007 Dec; 15(12):738-47. PubMed ID: 18063714.
    Abstract:
    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.
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