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Updated: Jul 18, 2026
Pseudofracture: An Acute Peripheral Tissue Trauma Model
Published on: April 18, 2011
The complex triplane fracture: ipsilateral tibial shaft and distal triplane fracture
1Division of Orthopaedic Surgery, University of Ottawa, Children's Hospital of Eastern Ontario Ottawa, Ontario, Canada.
Background:
The complex triplane fracture (ipsilateral tibial shaft and distal tibial triplane fracture) is a rare combination. It has not previously been described in the literature. This combination can be easily overlooked and has the potential for serious sequelae if it is missed.
Methods:
Six patients, having sustained this combined injury, were reviewed at a tertiary children's hospital. Clinical assessment, radiographs, computed tomographic scans, bone age, and scanogram assessment of leg length at maturity were completed.
Results:
Average age at injury was 14 years. Tibial fractures were midshaft or short oblique. There were 3 three-part and 3 two-part intra-articular distal tibial triplane fractures. Diagnosis of the distal triplane fracture was delayed in two cases. Treatment involved application of a long leg cast. No patients required open reduction. At follow-up (average, 22 months), all patients were asymptomatic. All fractures were well healed and there was no evidence of joint incongruity, or angular or rotational deformity. Leg length discrepancy averaged 6.8 mm.
Conclusion:
A high index of suspicion should be maintained to avoid missing this rare combination, as it has the potential for long-term sequelae.
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