The ankle x-rays show a tri-plane fracture.
- Vertical fracture of the distal tibial epiphysis.
- Horizontal fracture through the lateral aspect of the distal tibial physis.
- Oblique fracture of the distal tibial metaphysis.
CT scan images show the fracture clearly.
Tri-plane fracture is a Salter Harris Type IV injury and is typically seen in children aged 12-15 years. The mechanism of injury is ankle external rotation, and all such injuries need referral to an orthopaedician.
This patient was managed conservatively.