1: J Trauma  2001 Oct;51(4):714-6 The complex triplane fracture: ipsilateral tibial shaft and distal triplanefracture.Jarvis JG, Miyanji F.Division of Orthopaedic Surgery, University of Ottawa, Children's Hospital ofEastern Ontario Ottawa, Ontario, Canada.BACKGROUND: The complex triplane fracture (ipsilateral tibial shaft and distaltibial triplane fracture) is a rare combination. It has not previously beendescribed in the literature. This combination can be easily overlooked and hasthe potential for serious sequelae if it is missed. METHODS: Six patients,having sustained this combined injury, were reviewed at a tertiary children'shospital. Clinical assessment, radiographs, computed tomographic scans, boneage, and scanogram assessment of leg length at maturity were completed. RESULTS:Average age at injury was 14 years. Tibial fractures were midshaft or shortoblique. There were 3 three-part and 3 two-part intra-articular distal tibialtriplane fractures. Diagnosis of the distal triplane fracture was delayed in twocases. Treatment involved application of a long leg cast. No patients requiredopen reduction. At follow-up (average, 22 months), all patients wereasymptomatic. All fractures were well healed and there was no evidence of jointincongruity, or angular or rotational deformity. Leg length discrepancy averaged6.8 mm. CONCLUSION: A high index of suspicion should be maintained to avoidmissing this rare combination, as it has the potential for long-term sequelae.PMID: 11586164 [PubMed - indexed for MEDLINE]