A triplane fracture of the distal tibia usually occurs
during adolescence and occurs before complete closure of the distal tibial
physis. The distal tibial physis (growth plate) is a weak area which closes
from central to medial, with the lateral side being the last part to close. A
Triplane fracture is a Salter-Harris Type IV Fracture, involving all three
planes, the coronal (metaphysis), transverse (growth plate), and sagittal (epiphysis).
The fracture has several variations and occurs due to external rotation forces.
This fracture typically occurs in patients between 12-15 years of age.
Triplane fractures are complicated three-dimensional
fractures. A two-part fracture is a Salter-Harris Type IV. A Three-part
fracture is a combination of Salter-Harris Type III in an AP view and a Type II
in a lateral view. CT scans are helpful.
An ORIF is necessary if there is displacement of the
fragments of more than 2 mm.
