Distal tibial triplane fractures: long-term follow-up

The cases of 35 patients in whom a triplane fracture had been treated at the Ramón y Cajal Hospital were reviewed. The diagnosis of biplane and triplane fracture can now be made by standard radiograph. However, plain radiographs alone did not accurately demonstrate the configuration of the fracture, and computed tomography must be performed. Closed reduction should be attempted first. Failure to obtain or maintain (or both) an adequate closed reduction is an indication for operative treatment. Prognosis is surprisingly good. Only when adequate reduction (< 2 mm displacement) has not been achieved can degenerative changes be seen at long-term follow-up (> 5 years).