Triplane fractures: do we need cross-sectional imaging?

Schneidmueller, Dorien; Sander, Anna; Wertenbroek, Marieke W. J. L. A. E.; Wutzler, Sebastian; Kraus, Ralf; Marzi, Ingo; Laurer, Helmut

doi:10.1007/s00068-013-0338-7

Cited by 18 publications

(10 citation statements)

References 34 publications

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“…The commonly accepted treatment goal in transitional fractures is the anatomic reduction of the articular surface [10-17, 20, 33, 34], as longitudinal growth at the time of physeal plate maturation is complete, the remodeling potential of these fractures is limited [17,33,34]. We suggest CT scan with multiplanar reconstruction for displaced transitional fractures for a closer understanding of the fractures and to allow for better treatment planning [34,36,37]. Non-operative treatment (immobilization in a forearm cast for at least 4 to 6 weeks) of transitional fractures of the distal radius is recommended only for non-or minimal (less than 2 mm) displaced fractures or if anatomical reduction and maintenance of reduction could be achieved by closed manipulation.…”

Section: Discussionmentioning

confidence: 99%

Transitional fracture of the distal radius: a rare injury in adolescent athletes. Case series and literature review

et al. 2020

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Background: Transitional fractures are fractures in adolescents where partial closure of the epiphyseal growth plate has occurred. These fractures are most commonly reported in the distal tibia. With respect to the distal radius, only a few case reports describing transitional fractures exist. Furthermore, relatively little is known about epiphyseal closure of the distal radius. A case series of four transitional fractures of the distal radius is presented by comparing non-operative and operative treatment options. At present, this is the largest case series in the literature dealing with this rare injury. Case presentation: We present three cases of four transitional fractures of the distal radius including 1-year followup. Patient age ranged from 16 to 18 years including a gender ratio of two males to one female. Clinical and radiographic assessments took place 6 and 12 weeks and 1 year after trauma/surgery. Three transitional fractures were treated with open reduction and internal volar plate fixation followed by functional rehabilitation. One transitional fracture was treated non-operatively. All cases showed an excellent functional outcome. Conclusions: The primary treatment goal in transitional fractures is anatomic reduction of the articular surface. Nonoperative treatment of transitional fractures of the distal radius is the most commonly reported treatment option. Additionally, different fixation options have been described, including the use of Kirschner wires (K-wires) and lag screws. The presented cases demonstrate that volar plate fixation followed by functional rehabilitation is a valuable treatment option in significantly displaced transitional fractures of the distal radius. Furthermore, we discuss the pathogenesis as well as the different treatment options by critical reviewing the literature.

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Section: Discussionmentioning

confidence: 99%

Transitional fracture of the distal radius: a rare injury in adolescent athletes. Case series and literature review

et al. 2020

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“…CT scan is most commonly indicated for transitional fractures to study the configuration of fracture, the number of fracture fragments and displacement and also to plan the fixation. Though some authors have concluded that CT scan would not significantly change the way these fractures are managed, there is enough evidence in the literature to support the use of routine CT scan to analyse and treat these fractures [14][15][16][17]. Many a time, there would be a change of treatment plan after viewing CT imaging because of the significant intraarticular displacement that is difficult to appreciate on plain radiographs [16].…”

Section: Imagingmentioning

confidence: 99%

“…Though there is controversy on the routine need of CT scans for evaluation of triplane injuries [14][15][16]47], we feel that CT scan is mandatory in these fractures both for quantifying the displacement as well as planning the screws which primarily depends on the number and location of fragments (Fig. 9).…”

Section: Triplane Fracturesmentioning

confidence: 99%

Paediatric Ankle Fractures: Guidelines to Management

Venkatadass

Sangeet

Prasad

et al. 2020

IJOO

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Introduction Paediatric ankle fractures represents about 5% of all paediatric fractures. It is the most common physis to be injured in the lower limb accounting to approximately 15-20% of all physeal injuries. This article reviews the literature on this common injury which still has many controversial areas and gives guidelines to management based on the existing evidence along with clinical experience gained from a Level I trauma center. Classification The original Salter-Harris Classification with the additional types is a good system to guide on the management. The transitional fractures form a separate group with technically two broad types-biplane and triplane injuries. Though there are many sub-types in this group with some popular eponymous fractures, the treatment principles remain the same. Management A very low threshold for CT scan is recommended when there is a clinical suspicion of fracture with a negative radiograph or an intra-articular fracture in the radiograph especially in the adolescent age group. CT scan helps in accurate quantification of the intra-articular displacement and also helps to comprehend the fracture geometry better. All the intraarticular fractures with displacement > 2 mm need perfect anatomical reduction and stabilization. Assisted closed reduction and percutaneous fixation along with arthrogram to confirm articular congruity is acceptable as long as the reduction is perfect. Irrespective of the method of treatment, in children with more than 2 years of growth remaining it is important to counsel regarding the high incidence of pre-mature physeal closure and the need for regular follow-up.

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“…Eine genaue Differenzierung zwischen Twoplane-, Triplane-I-und -II-Frakturen ist oft nur anhand einer Schnittbildgebung möglich [10,11]. Sie wird v. a. zur Beurteilung des dorsalen Frakturabschnitts und bei vermeintlich undislozierten Übergangsfrakturen empfohlen.…”

Section: Diagnostikunclassified