ARTHROSCOPIC TREATMENT OF TRIPLANE FRACTURES OF THE ANKLE

Failure to obtain and/or maintain adequate closed reduction of triplan e ankle fractures is an indication for surgical reduction and internal fixation. Operative treatment requires anteromedial and/or anterolate ral incisions for adequate visualization of fracture fragments. The ad ded surgical trauma associated with operative treatment of these fract ures can be minimized without loss of efficacy using minimally invasiv e techniques under arthroscopic control. Arthroscopic reduction and in ternal fixation (ARIF) of two-part triplane fractures provides the adv antages of complete evacuation of fracture hemarthrosis, accurate and certain reduction of the articular surface, and secure fixation of fra cture fragments. Two patients treated with ARIF demonstrated rapid and complete fracture healing without complication. Follow-up at 6-12 mon ths showed no leg length discrepancy, angulation, swelling, persistent symptoms, or limitation of function. ARIF of triplane ankle fractures reduces surgical trauma, provides a method for accurate delineation o f fracture fragment orientation, and ensures accurate reduction and jo int congruity under direct visualization.