Triplane distal tibial epiphyseal fracture.

The uncommon type IV Salter-Harris distal tibial epiphyseal so-called triplane fractures has been described as a three-fragment fracture by several authors, but other descriptions based on roentgenograms alone include the injury among two-fragment fractures. We report here on one case with three fragments and five with two fragments. Good results have been obtained by closed methods, but there is more than 2 mm of joint incongruity after reduction, open reduction and internal fixation are indicated. Premature closure of the epiphyseal plate resulted but it was not an important consideration because the epiphyses were nearly closed in all of our patients.