Triplane fracture: A rare variant of type III physeal injury of distal femur in paediatric population

Abstract

Introduction: Distal femoral physeal fractures are commonly observed in children with open growth plates who experience direct trauma. Biplane fractures have been documented, but triplane fractures are exceedingly rare. We present the case of a 17-year-old male with an immature skeletal structure who sustained a direct blow to his right knee in a road traffic accident, leading to this uncommon injury. Case presentation: The patient underwent a knee X-ray initially, followed by a CT scan for a more detailed assessment. The CT scan confirmed the diagnosis of a distal femoral physeal triplane fracture. Subsequently, open reduction and internal fixation were performed using a lateral parapatellar approach. Discussion: Distal femoral physeal triplane fractures are infrequently reported in medical literature, highlighting the rarity of this injury. Accurate diagnosis necessitates meticulous radiological examination, with CT scans being particularly useful. Treatment involves achieving anatomical alignment and stabilizing the fracture with screws or K-wires. Given the potential complication of limb length discrepancy, long-term monitoring until skeletal maturity is crucial. Conclusion: This clinical case highlights the scarcity of documentation in the literature of distal femur physeal triplaner and underscores the significance of precise radiological evaluation for accurate diagnosis. Early surgical intervention, along with careful long-term monitoring, can help mitigate potential complications and ensure favorable outcomes in these rare cases.

Keywords

• Distal femur
• Fractures
• Triplane
• Physeal injuries
• Hoffa's