Edited by Amy Steele, David Evans - 7/1/2021
Descriptors
Pediatric ankle fractures, triplane ankle fracture
Exam Pearls
Traumatic ankle injury in child 10-17 years old
SH IV fracture in multiple planes (hence triplane, usually SH III on AP and II on lateral)
Occurs DURING physeal closure given the transitional way that the distal tibial physis closes.
Younger than tillaux fracture group
Usually from supination-external rotation injury
Predictable pattern of closure: central-->anteromedial-->posteromedial-->lateral
Workup
Radiographs: AP, lateral, mortise
Other imaging:. post cast CT scan to check displacement--mercedes benz (fracture pattern in 3 planes on axial cut)
Labs: Pre-op if needed
Other: Insert your text here
Management
Need for acute intervention: Yes, immobilization with reduction
Weight-bearing and range of motion: NWB no ROM at the ankle
Type of immobilization: Long leg cast to control rotation
Admission or discharge status: Depending on operative status, likely outpatient surgery
Anticoagulation: None
Antibiotics: Not indicated unless open
Surgical Indications
Absolute: >2mm displacement