Treatment Outcomes of Triplane and Tillaux Fractures of the Ankle in Adolescence

purpose. 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 nonweight 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. conclusion. Treatment outcome of triplane fractures of the distal tibia in children is good when guidelines are closely adhered to.

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“…The mean follow-up period was 14.2 (range, [9][10][11][12][13][14][15][16][17][18][19][20] weeks. All patients had excellent outcome.…”

Section: Resultsmentioning

confidence: 99%

Triplane Fractures of the Distal Tibia in Children

Tan

Chong

Mahadev

2013

J Orthop Surg (Hong Kong)

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“…Although CT scans and radiographs were found to be accurate to within 1 mm 50% of the time, the authors found that CT scans are more sensitive in detecting fracture displacements larger than 2 mm. 21 In addition, Kim et al 22 found that a better understanding of fracture configuration, such as that provided by CT, correlated with improved outcomes with triplane and Tillaux fractures. The role of magnetic resonance imaging (MRI) remains unclear.…”

Section: C 2dmentioning

confidence: 97%

Review of Distal Tibial Epiphyseal Transitional Fractures

Rosenbaum¹,

DiPreta²,

Uhl³

2012

Orthopedics

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The closure of the distal tibial physis occurs over an 18-month period between ages 12 and 15 years. During this time period, children are susceptible to several transitional fractures, so labeled because they are transitioning to skeletal maturity. In the setting of an external rotation force, triplane and Tillaux fractures can occur. These fractures, which present similarly to other Salter-Harris growth plate injuries, do not fit neatly into any 1 classification scheme and are not easily evaluated on plain radiographs. Computed tomography scans are required to optimally assess these fractures and to determine the need for closed vs open treatment. Regardless of which treatment modality is chosen, anatomic reduction is the goal. This article discusses the approach to these unique fractures.

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“…For medial triplane fractures, open reduction using an anteromedial approach has been proposed, whereas for the lateral triplane fractures an anterolateral approach is employed [13].…”

mentioning

confidence: 99%

“…Surgical interventions for the precise and safe reduction of displaced fractures include percutaneous Kirschner wire fixation or open reduction and internal fixation with cannulated cancellous transepiphyseal screws with special precautions to eschew the penetration of both the articular surface and physis [7,13,14]. For medial triplane fractures, open reduction using an anteromedial approach has been proposed, whereas for the lateral triplane fractures an anterolateral approach is employed [13].…”

mentioning

confidence: 99%