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Triplane Fracture

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​Complex SH IV fracture with components in all 3 planes

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  • 5-15% paediatric ankle fractures

  • Occurs during physeal closure- mean age 13.

  • MECHANISM: 

    • Supernation & external rotation.

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Associated fractures

  • fibular fractures

    • occurs in 50%

    • typically spiral fracture located proximal to the physis.

  • ipsilateral tibial shaft fractures

MANAGEMENT

  • Analgesia

  • REFER ORTHO

  • Displaced >2mm

    • Operative management

  • Displacement <2mm

    • Above knee backslab

    • Non weight bearing

    • CT scan may be required to confirm not displaced.

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