The Journal of Bone and Joint Surgery, Vol 60, Issue 8 1040-1046, Copyright © 1978 by Journal of Bone and Joint Surgery, Inc
Tibial fractures involving the ankle in children. The so-called triplane epiphyseal fracture
DR Cooperman, PG Spiegel and GS Laros
Triplane fractures of the distal end of the tibia in fifteen children
(average age, thirteen years) represented 6 per cent of 237 consecutive
epiphyseal fractures of the ankle. Thirteen children were treated by closed
methods (including manipulation) and two had open reduction of the
fractures. At an average of twenty-six months after injury, three of
fourteen patients showed roentgenographic evidence of premature symmetrical
epiphyseal closure with less than 0.5 centimeter of shortening and no
angular deformity. Of twelve children examined clinically, three had a 5 to
10-degree external rotation deformity and one patient also had an articular
incongruity due to inadequate reduction. In the five cases in which
tomograms were used to the medial malleolus, and the anteromedial part of
the epiphysis. The lateral fragment included the remainder of the epiphysis
together with a piece of posterior metaphysis with attached fibula.
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