A triplane fracture is a unique and complex injury primarily occurring in adolescents, typically involving the distal part of the tibia near the ankle joint. This fracture is characterized by three distinct fracture lines that form a unique configuration, which usually results from a combination of axial load and rotational forces, often seen during sports activities or high-impact falls. The classification of triplane fractures is based on the fact that they extend into the sagittal, coronal, and transverse planes, making them multifaceted and challenging to treat. These fractures are most common in individuals who are nearing skeletal maturity, where the growth plates are still open but close to fusion, highlighting the importance of prompt and precise diagnosis to prevent long-term complications.Clinical examination of a triplane fracture generally reveals significant swelling, tenderness, and a limited range of motion in the affected ankle. X-rays are essential for confirming the diagnosis, as they provide detailed images of the fracture lines and any associated displacement of bone fragments. In most cases, the presence of an accompanying fibula fracture can also be observed. Due to the intricate nature of this injury, treatment is critical, as improper management can lead to malunion or lingering functional impairment. In many instances, non-displaced triplane fractures may be managed conservatively with immobilization through casting or splinting, allowing for sufficient healing and alignment. However, displaced fractures may necessitate surgical intervention to restore proper anatomical positioning and stability through open reduction and internal fixation. The surgical approach often includes the use of screws and plates to properly align the fracture fragments, and careful attention must be paid to protect the surrounding growth plate. Post-operative rehabilitation is equally crucial, involving a gradual return to mobility and function while closely monitoring recovery through physical therapy. The prognosis for triplane fractures is generally favorable, particularly when managed appropriately, with many individuals regaining full function without significant long-term consequences. Nevertheless, potential complications, such as leg length discrepancies, malunion, or post-traumatic arthritis, may arise, emphasizing the importance of vigilant follow-up and monitoring. In summary, a triplane fracture presents a challenging yet manageable orthopedic condition that requires a comprehensive understanding of its mechanism of injury, careful diagnostic evaluation, and an appropriate treatment plan that prioritizes both immediate healing and long-term functionality in the young patient population. Understanding the specifics regarding triplane fractures aids healthcare providers in devising a tailored treatment approach to optimize patient outcomes and ensure a return to their previous level of activity.
