Fracture mapping and imaging analysis of triplane fracture of distal tibia in adolescents

doi:10.12307/2025.984

Abstract

Abstract: BACKGROUND: Because of its complex and unique spatial structure, the triplane fracture of the distal tibia only occurs in adolescents with epiphyseal closure, which is a great test for clinicians’ experience and understanding in the treatment. In recent years, fracture mapping technology has developed rapidly and has been widely used in trauma orthopedics.
OBJECTIVE: To draw a triplane fracture map of the distal tibia in adolescents by using fracture mapping technology, observe the shape, location, and frequency of the cross-sectional fracture line, and analyze the characteristics of the triplane fracture of the distal tibia.
METHODS: The medical records of 79 patients with triplane fractures of the distal tibia were retrospectively studied. The original CT image data were collected. The required two cross-sectional images were obtained by Mimics 21.0 software. The patient’s CT images were reset and fitted to the standard template in Photoshop 24.0 software, and all fracture lines were depicted and superimposed to generate a fracture map. The Matlab (r2023b) software was used to create a heat map to show the high-density and low-density fracture areas, and the distribution of fracture lines was analyzed.
RESULTS AND CONCLUSION: (1) Among the 79 adolescent patients included in this study, 73% were male and 27% were female, with an average age of 12.8±1.5 years (range, 10-15 years). (2) The fracture line of metaphysis mainly concentrated in the posterior side. The fracture line of the articular surface showed obvious “Y” type characteristics. The fracture line of this plane could be subdivided into “Y” type (18%), transverse type (32%), anteromedial notch type (33%) and other types (17%). The zonal fracture map showed that there were significant differences in the number of fracture lines passing through different regions (P < 0.01). (3) The formation of the “Y” shaped fracture line on the articular surface may be related to the anterior and posterior ligaments of the lower tibiofibula. The results show that the fracture map can provide an intuitive visual framework for the triplane fracture of the distal tibia, and provide references for further image classification, internal fixation design, and screw placement.

Key words: triplane fracture, tibia, adolescent, CT, fracture line, fracture map, fracture heat map

CLC Number:

Wang Bokai, Wang Zhiqiang, Zhou Hongyan, Li Junran, Wu Yiheng, Zhao Hongbo. Fracture mapping and imaging analysis of triplane fracture of distal tibia in adolescents[J]. Chinese Journal of Tissue Engineering Research, 2026, 30(9): 2248-2254.

Figures/Tables 7

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