Fig. 4.

A 12-year-old female sustained this triplane fracture due to a twisting injury while playing lacrosse. a–d AP radiograph reveals a SH-IV injury whereas on lateral a SH-II injury is appreciated, typical for triplane fractures. CT scans revealed more than 2 mm of gapping at the fracture line; for this reason, the patient was indicated for operative fixation. 6.5 cannulated screws were utilized to compress the posterior malleolar fracture first, followed by open reduction of the joint line and fixation of the latter by a 4.5 cannulated screw (h, i). Six months post-injury, fracture is healed and growth plates are closing (j, k). Patient has full range of motion compared to the opposite ankle and has resumed sports at her pre-injury level