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Related Concept Videos

Fractures: Bone Repair01:27

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Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
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The ankle is formed by the talocrural joint (crural = leg). It consists of the articulations between the talus bone of the foot and the distal ends of the tibia and fibula of the leg. The superior aspect of the talus bone is square-shaped and has three areas of articulation. The top of the talus articulates with the inferior tibia. This is the portion of the ankle joint that carries the body weight between the leg and foot. The sides of the talus are firmly held in position by the articulations...
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Functional Classification of Joints
The functional classification of joints is determined by the amount of mobility between the adjacent bones. Joints are functionally classified as a synarthrosis or immobile joint, an amphiarthrosis or slightly moveable joint, or as a diarthrosis, a freely moveable joint. Fibrous and cartilaginous joints can be functionally classified as either synarthroses  or amphiarthroses, whereas all synovial joints are classified as diarthroses.
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The femur is the body's longest and strongest bone spanning the thigh region. Its head articulates with the acetabulum of the hip bone to form the hip joint. A minor indentation on the medial side of the femoral head, called the fovea capitis, serves as the site of attachment for the ligament of the head of the femur. This weak ligament spans the femur and acetabulum and supports the hip joint. The narrowed region below the head is the neck of the femur. The inclination angle between the...
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Related Experiment Video

Updated: Jul 12, 2025

A Mouse Model of Ankle-Subtalar Complex Joint Instability
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Triplane ankle fracture patterns in paediatric patients.

Jasper Prijs1,2,3, Jaideep Rawat3,4, Kaj Ten Duis2

  • 1Department of Orthopaedic Surgery, Groningen University Medical Centre, Groningen, The Netherlands.

The Bone & Joint Journal
|November 1, 2023
PubMed
Summary

Triplane ankle fractures in children display a consistent Y-pattern, challenging the idea that physeal closure dictates the injury pattern. Ligamentous attachments appear more influential than age-related physeal changes.

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Area of Science:

  • Orthopaedic Surgery
  • Paediatric Trauma
  • Radiology

Background:

  • Triplane ankle fractures are complex injuries in adolescents.
  • Classic theories link fracture patterns to physeal closure, based on older studies.
  • These theories have not been re-evaluated with modern imaging techniques.

Purpose of the Study:

  • To investigate the correlation between triplane ankle fracture patterns and the advancing closure of the physis with age.
  • To challenge the long-standing assumption that physeal closure dictates triplane ankle fracture patterns.

Main Methods:

  • A fracture mapping study of 83 paediatric patients with triplane ankle fractures.
  • CT scans were analyzed by a Paediatric Orthopaedic Trauma Surgeon.
  • Fracture patterns were qualitatively analyzed using the modified Cole fracture mapping technique and assessed by a panel of six surgeons.

Main Results:

  • Fracture maps consistently showed a characteristic Y-pattern, irrespective of patient age.
  • No correlation was observed between fracture patterns and the advancing closure of the physis.
  • Ligamentous attachments, specifically between the inferior tibiofibular ligaments and the deltoid ligament, were identified as key factors.

Conclusions:

  • Triplane ankle fractures exhibit a consistent Y-pattern, not dictated by physeal closure.
  • Ligamentous attachments play a more significant role in determining fracture patterns than previously assumed.
  • This study challenges established orthopaedic teaching regarding these complex paediatric fractures.