Mittal Shivanshu, Prakash Atul, David Vivek Kumar, Sarkar Somit
Department of Joint Replacement and Orthopaedics, Tata Main Hospital, Jamshedpur, Jharkhand, India.
J Orthop Case Rep. 2021 Jul;11(7):24-28. doi: 10.13107/jocr.2021.v11.i07.2300.
Triplane fracture of ankle is a rare adolescent injury. Its association with ipsilateral tibial shaft fracture is very uncommon in pediatric orthopedic traumatology and rarely reported in the literature till date. Timely diagnosis and management is required to optimize the outcome and avoid complications.
This is a case of a 14-year-old male who sustained a twisting injury to his right leg during early phase of COVID-19 pandemic. He sustained a three-part lateral triplane fracture of the ankle with a concomitant displaced spiral fracture of the shaft of the right tibia. He underwent close reduction under fluoroscopy and above-knee casting for 10 weeks followed patellar tendon weight-bearing cast for 4 weeks. Both fractures healed uneventfully in 14 weeks with patient returning to full activities in 22 weeks.
The ankle injury in adolescent age group (12-15 years) can easily be missed in the presence of the more obvious tibial fracture and therefore, we recommend ankle assessment of all patients with tibial shaft fractures in this age group both clinically and radiologically.
三平面踝关节骨折是一种罕见的青少年损伤。在小儿骨科创伤学中，其与同侧胫骨干骨折相关的情况非常少见，迄今为止在文献中也鲜有报道。需要及时诊断和处理，以优化治疗效果并避免并发症。
这是一例14岁男性患者，在新冠疫情早期，其右腿遭受扭转损伤。他发生了三部分的踝关节外侧三平面骨折，同时伴有右胫骨干移位螺旋骨折。他在透视下进行了闭合复位，然后进行了10周的膝上石膏固定，随后使用髌腱承重石膏固定4周。两处骨折均在14周内顺利愈合，患者在22周时恢复了全部活动。
在青少年年龄组（12 - 15岁）中，踝关节损伤在存在更明显的胫骨干骨折时很容易被漏诊，因此，我们建议对该年龄组所有胫骨干骨折患者进行临床和影像学的踝关节评估。
