Presentation
Twist injury, for assessment of fracture extension.
Patient Data
Vertical fracture line through the distal tibial epiphysis abutting the articular surface. A horizontal fracture line through the lateral aspect of the growth plate and on the lateral view, an oblique fracture line through the metaphysis extending cranially into the diaphysis.
This is all in a pattern consistent with triplane fracture.
The fracture is better elucidated on the CT scan of the ankle. There is no displacement or intra-articular fragments.
Case Discussion
The case illustrates the typical imaging appearance of triplane fracture. It is considered a Salter-Harris type IV injuries with three fracture planes; a vertical fracture of the epiphysis, a horizontal fracture within the growth plate, and an oblique fracture of the metaphysis.