The triplane fracture of the distal tibia is anatomically complex. It
typically consists of a coronal fracture of the metaphysis, a transver
se fracture of the physis, and a sagittal, intra-articular fracture of
the epiphysis. We report an unusual variation of the triplane fractur
e which includes an extra-articular epiphyseal component involving the
medial malleolus. This is an important variant to recognize because i
t does not disrupt the distal tibial articular surface. This lack of a
rticular involvement allows for non-surgical management in contrast to
the usual triplane fracture which often requires open reduction and i
nternal fixation.