Clin Orthop Surg.  2010 Mar;2(1):34-38. 10.4055/cios.2010.2.1.34.

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

• Kim JR
• Song KH
• Song KJ
• Lee HS

• KMID: 1110347
• DOI: http://doi.org/10.4055/cios.2010.2.1.34

Abstract

BACKGROUND: To identify the fracture configuration and treatment results for patients with triplane and Tillaux fractures in the ankle joint.
METHODS
A retrospective study was performed on 14 patients with a more than one year follow-up. This study investigated the fracture configuration, concomitant fibula fracture, treatment methods and complications. The treatment outcomes were analyzed using modified Weber protocol.
RESULTS
Among the 14 cases, 11 were triplane fractures and 3 were Tillaux fractures. Seven were two part triplane fractures, and 4 were three part triplane fractures. Eight were lateral triplane fractures, and 3 were medial triplane fractures. A fibula fracture was accompanied by 7. The fibular fracture comprised of oblique fractures in all cases. A closed and open reduction was performed in 6 and 8 cases, respectively. All but one showed excellent treatment outcomes at the final follow-up. Traumatic arthritis developed in 1 case.
CONCLUSIONS
Precisely detecting the fracture configuration by computed tomography and understanding the injury mechanism have greatly improved the outcomes of triplane fractures and Tillaux fractures of the ankle in adolescent patients.

Keyword

Ankle; Adolescence; Triplane fracture; Tillaux fracture; Treatment outcome

MeSH Terms

Adolescent
Ankle Injuries/diagnosis/radiography/*surgery
Arthroscopy
Child
Female
Fracture Fixation, Internal
Humans
Intra-Articular Fractures/diagnosis/radiography/*surgery
Male
Tibial Fractures/diagnosis/radiography/*surgery
Tomography, Emission-Computed, Single-Photon
Tomography, X-Ray Computed

Figure

• 

  Fig. 1 Fourteen-year-old girl suffered from a physeal injury to the right distal tibia. (A) Preoperative radiographs showed Salter-Harris type III from the anteroposterior (AP) view and type IV from the lateral view, a medial malleolus fracture and a triplane fracture accompanied by a fibula fracture. (B) Computed tomography scan shows three part and lateral triplane fractures. (C) Postoperative radiograph after an open reduction and fixation with screws and percutaneous Kirschner-wire. (D) At postoperative 1 yr, congruency and no physeal arrest of the ankle joint were observed.

• 

  Fig. 2 Sixteen-yr-old boy suffered from a physeal injury of the right distal tibia. (A) Preoperative radiographs showed Salter-Harris type IV triplane fracture of the distal tibia. (B) Computed tomography scan shows two part and medial triplane fractures. (C) Postoperative radiographs after open reduction and cannulated screw fixation, inadequate reduction with articular incongruency was observed. (D) At postoperative 9 yr, mild degenerative changes and an anterior bony spur of the ankle joint were observed.

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