Chi Zhang1, Chongbo Huang1, Jinsong Hong1, Yunfeng Li1, Jianwei Hu1, Weizhong Yu1, Hua Wang2* and Chongxia Huang1*
1Department of Orthopaedic Surgery, Guangzhou Orthopedic Hospital, Guangzhou, P.R. China
2Department of Orthopaedics, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, P.R. China
Objectives: We designed a prospective study to confirm the hypothesis that acute triplane fracture of distal tibia can be treated conservatively with good range of motion and daily mobility without pain.Methods: Forty-six patients participated and completed the study, including 35 male and 11 female. Inclusion criteria was, patients with acute triplane fractures (≤ 3 days) who received closed reduction and cast immobilization. Clinical investigation and the foot and ankle outcome score (FAOS) survey were done. X-rays and computed tomography scan of the ankles were obtained at follow-up.Results: Fractures were 2-parts in 33 and 3-parts in 13 patients, fracture displacement were <2 mm in 21 patients and ≥ 2 mm in 25 patients, and 18 patients had concomitant fibular fractures. All patients were treated conservatively (cast immobilization with closed reduction). The mean period of cast was 4.3 ± 0.6 weeks; non-weight-bearing in a boot for 3 days, and follow-up period was 63.0 ± 5.4 months. All patients had good outcome, no one has ankle osteoarthritis on X-rays and CT scans at final follow-up. Mean FAOS score was 97.89 ± 6.15, with FAOS pain 38.70 ± 4.00, FAOS function 49.20 ± 2.29, alignment 10.00 ± 0.00. Patients had full range of motion, good daily mobility and no pain during walking.Conclusion: Results confirm the benefit of conservative treatment in acute triplane fracture of distal tibia that conservative treatment was sufficient to reestablish ankle stability, allowing complete recovery of ankle Range of motion (ROM) and reducing the risk of early degenerative joint disease, and it is also cost-effective.
Triplane fracture; Ankle; Closed reduction; Outcome
Zhang C, Huang C, Hong J, Li Y, Hu J, Yu W, et al. Closed Reduction Treatment and Outcome of Triplane Fracture of the Distal Tibia: Retrospective Study of 46 Cases. Clin Surg. 2018; 3: 2088.