Diagnosis, Treatment, and Potential Complications of Triplane Ankle Fractures in Pediatric Patients: A Systematic...

Background/Objectives: Triplane ankle fractures represent a complex fracture type in pediatric patients. These fractures can prove challenging due to the involvement of multiple fracture planes and variations in segment fragmentation. With increasing literature pertaining to the treatment of triplane fractures and the limitations of previous systematic reviews, the aim of this review is to summarize recent data on the diagnosis, treatment, and complications of pediatric triplane ankle fractures. Methods: This systematic review was conducted following PRISMA guidelines and searched five major databases up to July 2024. The inclusion criteria focused on observational studies and randomized controlled trials in pediatric triplane fractures. Case reports, cadaveric studies, and systematic reviews were excluded. Articles were screened and graded using the MINORS tool for quality assessment. Data were extracted on demographics, fracture types, treatment approaches, and outcomes. Results: A total of 34 studies met the inclusion criteria. The use of CT scans in combination with radiographs was common, and two-part fractures were the most frequently observed type. Surgical treatment, particularly open reduction with internal fixation, was preferred, while conservative surgical treatment remains under-reported. Complications were minimal, with limb length discrepancy being the most common. Conclusions: This review highlights the increased use of CT for diagnosing triplane fractures and the preference of certain surgical interventions. Conservative treatment approaches, though less studied, may offer alternatives in moderate cases. This review emphasizes the need for further research on conservative treatment outcomes, longer follow-ups, and randomized controlled trials to refine treatment strategies for this complex fracture pattern.