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Our 12-year old daughter was out snowboarding and broke her ankle. They told us it's a triplanar fracture. We saw it on X-rays and the CT scan, so we know what it looks like. What's the prognosis for something like this?

Triplanar fractures of the ankle represent three separate breaks in the bones. The breaks occur in three different planes or directions. There's a fracture from front-to-back, side-to-side, and top-to-bottom.

These kinds of fractures occur in older children and young teens whose growth plates have not closed yet. The growth plates do not all close at the same time. This means the overall prognosis depends on the status of each individual fracture.

Premature closure of the growth centers is a major concern with this type of fracture. If the child is years away from skeletal maturity, deformity and uneven leg length can develop.

One other important factor in the prognosis is how well the fracture is reduced. With proper reduction, the bones are brought back into place. The joint surfaces match up and there are no gaps in the involved bones.

In some cases, even good fracture reduction isn't enough to guarantee an excellent result. Sometimes the bone fragments start to drift apart after reduction. And sometimes there's more damage to the surface of the joint than can be seen on X-ray or CT scans. When this is the case, patients may only obtain a poor to fair result.

With a proper diagnosis and the correct treatment, many youngsters do have an excellent outcome. You can certainly ask your surgeon what to expect based on all the current factors.

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