Kärrholm J
Department of Orthopaedics, Sahlgren Hospital, Göteborg, Sweden.
J Pediatr Orthop B. 1997 Apr;6(2):91-102.
The triplane fracture of the distal tibia consists of several anatomic types, including two to four principal fracture fragments. According to previous calculations, 7% of all ankle fractures in girls and 15% in boys birth to 18 years old who have open growth plates are triplane fractures. In this update of a previous study and literature review of 209 cases (108 boys and 101 girls), the mean ages in boys and girls were 14.8 and 12.8 years, respectively (P < 0.00005). The triplane fracture did not occur in children younger than 10 and not in those older than 16.7 years. Thirty-five percent of the cases were treated without reduction, 30% with closed reduction, and 35% with open reduction. The choice of treatment depended on many variations in the materials reviewed. Excellent results were reported in 79% of 184 cases with follow-up. Neither age, sex, stage, nor treatment had a consistent influence on the frequency of less-than-excellent results. There was a weak tendency to deteriorating results with time to follow-up (r = 0.19, P = 0.016). Inadequate reduction seemed to be an important factor in the few cases with fair or poor results (4.7%), even if this presumption could not be verified statistically.
胫骨远端三平面骨折包括几种解剖类型，包括两到四个主要骨折碎片。根据以往的计算，在骨骺未闭的18岁以下女孩中，三平面骨折占所有踝关节骨折的7%，男孩中占15%。在这项对209例病例（108例男孩和101例女孩）的既往研究更新及文献综述中，男孩和女孩的平均年龄分别为14.8岁和12.8岁（P < 0.00005）。三平面骨折在10岁以下儿童和16.7岁以上儿童中未发生。35%的病例未行复位治疗，30%行闭合复位，35%行切开复位。治疗方法的选择取决于所回顾资料中的许多差异。在184例有随访的病例中，79%报告了良好的结果。年龄、性别、分期或治疗方法对疗效欠佳的频率均无一致影响。随着随访时间的延长，疗效有微弱的恶化趋势（r = 0.19，P = 0.016）。复位不充分似乎是少数疗效一般或较差病例（4.7%）中的一个重要因素，尽管这一推测无法通过统计学验证。
