Arthroscopic treatment of triplane fractures of the ankle

Failure to obtain and/or maintain adequate closed reduction of triplane ankle fractures is an indication for surgical reduction and internal fixation. Operative treatment requires anteromedial and/or anterolateral incisions for adequate visualization of fracture fragments. The added surgical trauma associated with operative treatment of these fractures can be minimized without loss of efficacy using minimally invasive techniques under arthroscopic control. Arthroscopic reduction and internal fixation (ARIF) of two-part triplane fractures provides the advantages of complete evacuation of fracture hemarthrosis, accurate and certain reduction of the articular surface, and secure fixation of fracture fragments. Two patients treated with ARIF demonstrated rapid and complete fracture healing without complication. Follow-up at 6-12 months showed no leg length discrepancy, angulation, swelling, persistent symptoms, or limitation of function. ARIF of triplane ankle fractures reduces surgical trauma, provides a method for accurate delineation of fracture fragment orientation, and ensures accurate reduction and joint congruity under direct visualization.