TREATMENT OF TRIPLANE FRACTURE ANKLE FRACTURES ASSOCIATED WITH IPSILATERAL TIBIAL FRACTURES USING A NOVEL APPROACH

Area of Science:

• Orthopedic surgery
• Pediatric traumatology
• Fracture management

Background:

• Triplane ankle fractures and tibial shaft fractures often occur concomitantly in pediatric patients.
• Optimal management strategies for this combined injury pattern require further investigation.

Purpose of the Study:

• To propose and evaluate a novel three-step surgical approach for treating concomitant triplane and tibial shaft fractures.
• To assess the efficacy and outcomes of this treatment in a pediatric cohort.

Main Methods:

• Retrospective study (2001-2019) of seven patients with combined triplane and tibial shaft fractures.
• Three-step surgical protocol: (1) Salter-Harris II triplane fracture fixation, (2) Salter-Harris II/IV fracture fixation with cannulated screws, (3) tibial fracture fixation with flexible titanium nails.
• Collection of general, clinical, radiographic data, and complication records.

Main Results:

• Seven patients (mean age 14 years) with a mean follow-up of 6.4 years were included.
• Fracture types varied: triplane (2-3 fragments, Salter-Harris II/IV) and tibial (oblique, spiral).
• All triplane and tibial fractures achieved consolidation without significant displacement; no physeal damage was observed.

Conclusions:

• The proposed three-step treatment is effective for managing associated triplane and tibial shaft fractures.
• This approach demonstrates successful outcomes in pediatric patients with this complex injury pattern.
• Further research can validate this technique for broader clinical application.