Ipsilateral Tibial Shaft Fracture and Distal Tibial Triplane Fracture with an Intact Fibula: A Case Report

Rover, Walter B Sprenger De; Alazzawi, Sulaiman; Hallam, P.; Walton, N. P.

doi:10.1177/230949901101900321

Cited by 10 publications

(7 citation statements)

References 7 publications

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“…Sheffer et al, however in 2020, found an incidence of 2.15% of triplane injuries associated with tibia shaft fracture in a retrospective analysis of 517 fractures [25]. The treatment protocols vary with simple plaster cast immobilization, open/closed reduction with or without internal or external fixation all being described in the literature [6,12]. Oblique or spiral tibial fractures in children are known to unite with good outcomes even with intact fibula when treated with a well-molded plaster cast.…”

Section: Discussionmentioning

confidence: 99%

“…Orthopedic surgeons should be aware of such association of tibia fractures, especially spiral fractures, with ankle injuries. If unrecognized, it can lead to premature physeal closure, angular deformity, and degenerative changes in ankle [ 11 , 12 , 13 ]. However, as these injuries occur almost at the end of physeal growth, they rarely can result in growth arrest/limb length discrepancies [ 10 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

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Management of Adolescent Three-Part Lateral Triplane Ankle Fracture with Ipsilateral Shaft of Tibia Fracture and Intact Fibula in COVID Pandemic: A Case Report with Review of Literature

Mittal

Prakash

David

et al. 2021

JOCR

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Introduction: 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. Case Report: 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. Conclusion: 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. Keywords: Triplane ankle fracture, tibia shaft fracture, adolescent.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Management of Adolescent Three-Part Lateral Triplane Ankle Fracture with Ipsilateral Shaft of Tibia Fracture and Intact Fibula in COVID Pandemic: A Case Report with Review of Literature

Mittal

Prakash

David

et al. 2021

JOCR

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“…Recently a limited number of new cases suffering from ipsilateral tibia shaft and distal triplane fracture have been presented. They were all recorded in adolescents [42][43][44][45][46][47] .…”

Section: Editorialmentioning

confidence: 99%

Concomitant Tibia Shaft and Distal Triplane Fractures

Sferopoulos¹

2018

International Journal of Radiology

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Concomitant tibia shaft fracture and triplane fracture of the distal tibia are very rare in the pediatric orthopaedic traumatology. The very limited number of cases in the world literature has all been documented in older children or adolescent patients. Appropriate diagnostic evaluation and treatment is required to minimize the incidence of delayed or missed diagnosis of the ankle injury, prevent complications and optimize outcomes of both fractures. A new case as well as an extensive review of the literature is presented in this editorial.

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“…The degree of fracture displacement and soft-tissue injury determined whether limbs were immobilized initially with plaster back-slabs or a 1,3,4 Trauma and Orthopaedics Department, Leeds Teaching Hospitals NHS Trust, UK temporary mono-lateral external fixator. Open fractures were treated in accordance with BOAST 4 guidelines.…”

Section: Clinical Operative and Postoperative Managementmentioning

confidence: 99%

“…Open reduction and internal fixation were used. 1 In this particular case, the tibial shaft fracture was stabilized with a plate and a single cannulated lag screw used for the physeal injury. Weight-bearing was restricted for the first 6 weeks following which weight-bearing, as tolerated, was permitted in a removable below knee splint.…”

Section: Introductionmentioning

confidence: 99%

Complex Tibial Shaft Fractures in Children Involving the Distal Physis Managed with the Ilizarov Method

Rogers

Tan

Foster

et al. 2014

Strategies in Trauma and Limb Reconstruction

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Introduction: Segmental fractures in the juvenile distal tibia with physeal involvement present specific challenges. Injury to the growth plate may be overlooked, potentially resulting in late sequelae. Fracture stabilization can be complex. Previous reports of management of such an injury are by open reduction and internal fixation. This study reviews the management and outcome of a group of such patients treated with Ilizarov external fixators. Materials and methods: Patients aged 16 or younger treated in our unit between March 2013 and November 2014 by Ilizarov circular fine wire fixation for tibial fractures with ipsilateral physeal injuries were identified. Retrospective collection of patient demographics, fracture classification, treatment pathways, fixation methods, postoperative follow-up, outcomes, and complications was undertaken. Results: Eight patients were identified; two had Gustilo and Anderson grade IIIA open injuries. All were managed definitively using an Ilizarov external fixator in combination with percutaneous screw fixation of the physeal component as required. All patients were ambulant during treatment and were allowed unrestricted weight-bearing immediately postoperative. All but one attended school. All fractures united. In follow-up, one patient had a distal tibial physeal growth arrest, but there were no other complications. Conclusion: Pediatric patients with complex distal tibial fractures should be scrutinized for concomitant physeal injury. Where identified treatment, using a combination of internal fixation and an Ilizarov fixator can be considered.

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Ipsilateral Tibial Shaft Fracture and Distal Tibial Triplane Fracture with an Intact Fibula: A Case Report

Cited by 10 publications

References 7 publications

Management of Adolescent Three-Part Lateral Triplane Ankle Fracture with Ipsilateral Shaft of Tibia Fracture and Intact Fibula in COVID Pandemic: A Case Report with Review of Literature

Management of Adolescent Three-Part Lateral Triplane Ankle Fracture with Ipsilateral Shaft of Tibia Fracture and Intact Fibula in COVID Pandemic: A Case Report with Review of Literature

Concomitant Tibia Shaft and Distal Triplane Fractures

Complex Tibial Shaft Fractures in Children Involving the Distal Physis Managed with the Ilizarov Method

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