eMedicine Specialties > Orthopedic Surgery > Trauma

Triplane Fracture: Multimedia

Author: John L Abt, DO, FACEP, FACFE, Clinical Associate Professor and Senior Consulting Staff, Department of Emergency Medicine, Mount Sinai Medical Center of Miami
Coauthor(s): Vinod K Panchbhavi, MD, FRCS, FACS, Associate Professor, Chief, Division of Foot and Ankle Surgery, Department of Orthopedics, University of Texas Medical Branch School of Medicine
Contributor Information and Disclosures

Updated: Jun 12, 2009

Multimedia

(A) The distal tibial growth plate begins to clos...
(Enlarge Image)
Media file 1: (A) The distal tibial growth plate begins to close with a centrally located epiphyseal hump and proceeds medially, with posterior closure occurring before anterior closure. Following medial closure, the lateral tibial growth plate then closes progressively from the posteromedial area (B) to the anterolateral area (C, D). The entire process of physeal closure usually spans a period of 18 months. This process generally occurs when the individual is aged 12-15 years (mean age is 13.5 years, age range is 10-18 years), with complete closure occurring earlier in girls than in boys.
[ CLOSE WINDOW ]
(A) The distal tibial growth plate begins to clos...

(A) The distal tibial growth plate begins to close with a centrally located epiphyseal hump and proceeds medially, with posterior closure occurring before anterior closure. Following medial closure, the lateral tibial growth plate then closes progressively from the posteromedial area (B) to the anterolateral area (C, D). The entire process of physeal closure usually spans a period of 18 months. This process generally occurs when the individual is aged 12-15 years (mean age is 13.5 years, age range is 10-18 years), with complete closure occurring earlier in girls than in boys.

Triplane fracture involves the tibial metaphysis,...
(Enlarge Image)
Media file 2: Triplane fracture involves the tibial metaphysis, tibial growth plate (physis), and the epiphysis. This image depicts each of the involved anatomic areas. It is important to recall the structural lines of development and maturation of the metaphysis, physis, and epiphysis, as they relate to the triplane fracture. Note that forces transmitted to the physis and epiphysis create fracture lines consistent with the maturity of these structures. For an unfused growth plate, separation is likely to occur here. When the growth plate is fused (closed), the avulsed portion is likely the most recent portion of the growth plate that has fused. This part represents the weakest (least calcified and least matured) portion of the physis. Frequently this involves the anterolateral growth plate.
[ CLOSE WINDOW ]
Triplane fracture involves the tibial metaphysis,...

Triplane fracture involves the tibial metaphysis, tibial growth plate (physis), and the epiphysis. This image depicts each of the involved anatomic areas. It is important to recall the structural lines of development and maturation of the metaphysis, physis, and epiphysis, as they relate to the triplane fracture. Note that forces transmitted to the physis and epiphysis create fracture lines consistent with the maturity of these structures. For an unfused growth plate, separation is likely to occur here. When the growth plate is fused (closed), the avulsed portion is likely the most recent portion of the growth plate that has fused. This part represents the weakest (least calcified and least matured) portion of the physis. Frequently this involves the anterolateral growth plate.

In a 2-part triplane fracture, 3 fracture lines a...
(Enlarge Image)
Media file 3: In a 2-part triplane fracture, 3 fracture lines are identified in each of the transverse, coronal, and sagittal planes. The first fracture line in the transverse (horizontal) plane is through the growth plate (physis), leaving the anteromedial portion of the physis attached to the distal tibia. The second fracture line is in the sagittal (anteroposterior) plane through the epiphysis, lateral to the original formation of the epiphyseal fusion hump. The third fracture line is in the coronal plane and courses superiorly through the posterior metaphysis, producing a posterior metaphyseal spike. The resulting 2 fragments are (1) a fragment consisting of the posteromedial and lateral portions of the epiphysis attached to a posterior metaphyseal spike and (2) the distal tibia, with the anteromedial epiphysis attached.
[ CLOSE WINDOW ]
In a 2-part triplane fracture, 3 fracture lines a...

In a 2-part triplane fracture, 3 fracture lines are identified in each of the transverse, coronal, and sagittal planes. The first fracture line in the transverse (horizontal) plane is through the growth plate (physis), leaving the anteromedial portion of the physis attached to the distal tibia. The second fracture line is in the sagittal (anteroposterior) plane through the epiphysis, lateral to the original formation of the epiphyseal fusion hump. The third fracture line is in the coronal plane and courses superiorly through the posterior metaphysis, producing a posterior metaphyseal spike. The resulting 2 fragments are (1) a fragment consisting of the posteromedial and lateral portions of the epiphysis attached to a posterior metaphyseal spike and (2) the distal tibia, with the anteromedial epiphysis attached.

In a 3-part triplane fracture, the 3 fracture lin...
(Enlarge Image)
Media file 4: In a 3-part triplane fracture, the 3 fracture lines noted in Image 2 are present in each of the 3 anatomic planes; however, the fracture line in the coronal plane is complete in its course through the epiphysis and posterior metaphysis. The 3 fracture fragments thus produced are (1) a rectangular fragment of the anterolateral portion of the epiphysis, (2) the remainder of the epiphysis with an attached posterior spike of the distal tibial metaphysis, and (3) the tibial shaft with the proximal metaphysis and anteromedial epiphysis.
[ CLOSE WINDOW ]
In a 3-part triplane fracture, the 3 fracture lin...

In a 3-part triplane fracture, the 3 fracture lines noted in Image 2 are present in each of the 3 anatomic planes; however, the fracture line in the coronal plane is complete in its course through the epiphysis and posterior metaphysis. The 3 fracture fragments thus produced are (1) a rectangular fragment of the anterolateral portion of the epiphysis, (2) the remainder of the epiphysis with an attached posterior spike of the distal tibial metaphysis, and (3) the tibial shaft with the proximal metaphysis and anteromedial epiphysis.

Lateral radiograph of a triplane fracture illustr...
(Enlarge Image)
Media file 5: Lateral radiograph of a triplane fracture illustrates the following: Yellow arrows indicate the horizontal component of the fracture through the physis (growth plate), red arrows indicate the vertical fracture line in the coronal plane involving the metaphyseal spike complex, black arrows point to the posterior margin of the metaphyseal spike, and purple arrows indicate the associated fibular fracture. This image represents one of the first known published images of this type of 2-part triplane fracture.
[ CLOSE WINDOW ]
Lateral radiograph of a triplane fracture illustr...

Lateral radiograph of a triplane fracture illustrates the following: Yellow arrows indicate the horizontal component of the fracture through the physis (growth plate), red arrows indicate the vertical fracture line in the coronal plane involving the metaphyseal spike complex, black arrows point to the posterior margin of the metaphyseal spike, and purple arrows indicate the associated fibular fracture. This image represents one of the first known published images of this type of 2-part triplane fracture.

Radiograph of a triplane fracture. The anterior-...
(Enlarge Image)
Media file 6: Radiograph of a triplane fracture. The anterior-posterior view of the distal tibia and epiphysis is illustrated as follows: Yellow arrows indicate the horizontal fracture component through the growth plate, white arrows indicate the vertical fracture through the epiphysis in the sagittal plane, and black arrows outline the superior edges of the posterior metaphyseal spike. An associated fibula fracture is present. In this left-sided 2-part triplane fracture, medial is to the viewer's left, and lateral is to the right. This image represents one of the first known published images of this type of 2-part triplane fracture.
[ CLOSE WINDOW ]
Radiograph of a triplane fracture. The anterior-...

Radiograph of a triplane fracture. The anterior-posterior view of the distal tibia and epiphysis is illustrated as follows: Yellow arrows indicate the horizontal fracture component through the growth plate, white arrows indicate the vertical fracture through the epiphysis in the sagittal plane, and black arrows outline the superior edges of the posterior metaphyseal spike. An associated fibula fracture is present. In this left-sided 2-part triplane fracture, medial is to the viewer's left, and lateral is to the right. This image represents one of the first known published images of this type of 2-part triplane fracture.

Digital 3-dimensional helical CT scan reconstruct...
(Enlarge Image)
Media file 7: Digital 3-dimensional helical CT scan reconstruction of a rare type of triplane fracture. The image shown is of the inferior surface of the tibial epiphysis. Medially (viewer's left) is the distal tibial malleolus. Laterally (viewer's right) is the distal fibula/lateral malleolus. Fracture lines exist through the tibial epiphysis in the coronal, sagittal, and horizontal planes. The posterolateral fragment of the epiphysis is attached to the posterior metaphyseal spike rather than the more common anterolateral segment of the epiphysis. This image represents one of the first known published images of this type of 2-part triplane fracture.
[ CLOSE WINDOW ]
Digital 3-dimensional helical CT scan reconstruct...

Digital 3-dimensional helical CT scan reconstruction of a rare type of triplane fracture. The image shown is of the inferior surface of the tibial epiphysis. Medially (viewer's left) is the distal tibial malleolus. Laterally (viewer's right) is the distal fibula/lateral malleolus. Fracture lines exist through the tibial epiphysis in the coronal, sagittal, and horizontal planes. The posterolateral fragment of the epiphysis is attached to the posterior metaphyseal spike rather than the more common anterolateral segment of the epiphysis. This image represents one of the first known published images of this type of 2-part triplane fracture.

Two-dimensional helical CT scan image of the frac...
(Enlarge Image)
Media file 8: Two-dimensional helical CT scan image of the fracture observed in Image 3 prior to 3-dimensional reconstruction. PLEF represents the posterolateral epiphyseal fragment. DF is the distal fibula. The posteromedial and the entire portion of the anterior epiphysis are intact. This image represents one of the first known published images of this type of 2-part triplane fracture.
[ CLOSE WINDOW ]
Two-dimensional helical CT scan image of the frac...

Two-dimensional helical CT scan image of the fracture observed in Image 3 prior to 3-dimensional reconstruction. PLEF represents the posterolateral epiphyseal fragment. DF is the distal fibula. The posteromedial and the entire portion of the anterior epiphysis are intact. This image represents one of the first known published images of this type of 2-part triplane fracture.

Lateral view at 60 days postoperatively of this 3...
(Enlarge Image)
Media file 9: Lateral view at 60 days postoperatively of this 3-part triplane fracture in a 14-year-old male demonstrates accurate anatomic reduction. Two compression screws have been placed through a posterolateral incision. A vertical sclerotic line appears above, through, and below the screws, indicating healing of the realigned posterior metaphyseal spike. A 0.062 inch smooth Kirschner wire is observed (see Image 10).
[ CLOSE WINDOW ]
Lateral view at 60 days postoperatively of this 3...

Lateral view at 60 days postoperatively of this 3-part triplane fracture in a 14-year-old male demonstrates accurate anatomic reduction. Two compression screws have been placed through a posterolateral incision. A vertical sclerotic line appears above, through, and below the screws, indicating healing of the realigned posterior metaphyseal spike. A 0.062 inch smooth Kirschner wire is observed (see Image 10).

Anteroposterior view at 60 days postoperatively o...
(Enlarge Image)
Media file 10: Anteroposterior view at 60 days postoperatively of this 3-part triplane fracture demonstrates accurate anatomic reduction and 2 compression screws fixating the posterior metaphyseal spike. The horizontal 0.062 inch smooth Kirschner wire is accurately placed in the epiphysis from a medial approach through a single stab incision. Midway along the Kirschner wire a vertical line in the sagittal plane is observed, representing the original fracture through the epiphysis. Note that all fixation devices avoid the tibial growth plate.
[ CLOSE WINDOW ]
Anteroposterior view at 60 days postoperatively o...

Anteroposterior view at 60 days postoperatively of this 3-part triplane fracture demonstrates accurate anatomic reduction and 2 compression screws fixating the posterior metaphyseal spike. The horizontal 0.062 inch smooth Kirschner wire is accurately placed in the epiphysis from a medial approach through a single stab incision. Midway along the Kirschner wire a vertical line in the sagittal plane is observed, representing the original fracture through the epiphysis. Note that all fixation devices avoid the tibial growth plate.

More on Triplane Fracture

Overview: Triplane Fracture
Workup: Triplane Fracture
Treatment: Triplane Fracture
Follow-up: Triplane Fracture
Multimedia: Triplane Fracture
References
Further Reading
[ CLOSE WINDOW ]

References

  1. Schnetzler KA, Hoernschemeyer D. The pediatric triplane ankle fracture. J Am Acad Orthop Surg. Dec 2007;15(12):738-47. [Medline].

  2. von Laer L. Classification, diagnosis, and treatment of transitional fractures of the distal part of the tibia. J Bone Joint Surg Am. Jun 1985;67(5):687-98. [Medline].

  3. Garcia-Mata S, Hidalgo-Ovejero A. Triplane fracture of the distal radius. J Pediatr Orthop B. Jul 2006;15(4):298-301. [Medline].

  4. Kanellopoulos AD, Yiannakopoulos CK, Badras LS. Triplane fracture of the proximal tibia. Am J Orthop. Sep 2003;32(9):452-4. [Medline].

  5. Patel S, Haddad F. Triplane fractures of the ankle. Br J Hosp Med (Lond). Jan 2009;70(1):34-40. [Medline].

  6. Cummings RJ. Triplane ankle fracture with deltoid ligament tear and syndesmotic disruption. J Child Orthop. Feb 2008;2(1):11-4. [Medline].

  7. Heusch WL, Albers HW. Intramalleolar triplane fracture with osteochondral talar defect. Am J Orthop. May 2008;37(5):262-6. [Medline].

  8. Johnson EW Jr, Fahl JC. Fractures involving the distal epiphysis of the tibia and fibula in children. Am J Surg. May 1957;93(5):778-81. [Medline].

  9. Ehalt W. Verletzungen bei kindern und jugendlichen. Stuttgart, Germany: Ferdinand Enke Verlag;. 1961: 403-10.

  10. Titze VA. Sprunggelenksverletzungen bei kindern. Z Kinderchir. 1967;4:400-10.

  11. Marmor L. An unusual fracture of the tibial epiphysis. Clin Orthop. Nov-Dec 1970;73:132-5. [Medline].

  12. Lynn MD. The triplane distal tibial epiphyseal fracture. Clin Orthop. Jul-Aug 1972;86:187-90. [Medline].

  13. Cooperman DR, Spiegel PG, Laros GS. Tibial fractures involving the ankle in children. The so-called triplane epiphyseal fracture. J Bone Joint Surg [Am]. Dec 1978;60(8):1040-6. [Medline].

  14. Denton JR, Fischer SJ. The medial triplane fracture: report of an unusual injury. J Trauma. Nov 1981;21(11):991-5. [Medline].

  15. von Laer L. Classification, diagnosis, and treatment of transitional fractures of the distal part of the tibia. J Bone Joint Surg Am. Jun 1985;67(5):687-98. [Medline].

  16. Ertl JP, Barrack RL, Alexander AH, VanBuecken K. Triplane fracture of the distal tibial epiphysis. Long-term follow-up. J Bone Joint Surg Am. Aug 1988;70(7):967-76. [Medline].

  17. Vahvanen V, Aalto K. Classification of ankle fractures in children. Arch Orthop Trauma Surg. 1980;97(1):1-5. [Medline].

  18. Landin LA, Danielsson LG. Children''s ankle fractures. Classification and epidemiology. Acta Orthop Scand. Aug 1983;54(4):634-40. [Medline].

  19. Devalentine SJ. Epiphyseal injuries of the foot and ankle. Clin Podiatr Med Surg. Jan 1987;4(1):279-310. [Medline].

  20. Mac Nealy GA, Rogers LF, Hernandez R, Poznanski AK. Injuries of the distal tibial epiphysis: systematic radiographic evaluation. AJR Am J Roentgenol. Apr 1982;138(4):683-9. [Medline].

  21. Jones S, Phillips N, Ali F. Triplane fractures of the distal tibia requiring open reduction and internal fixation. Pre-operative planning using computed tomography. Injury. May 2003;34(4):293-8. [Medline].

  22. Junglee NA, Belthur MV, Hemmadi S, Thomas RH. A triplane fracture of the distal tibia complicated by dislocation of the fibula. Foot Ankle Int. Apr 2007;28(4):516-9. [Medline].

  23. Healy WA 3rd, Starkweather KD, Meyer J, Teplitz GA. Triplane fracture associated with a proximal third fibula fracture. Am J Orthop. Jun 1996;25(6):449-51. [Medline].

  24. Shin AY, Moran ME, Wenger DR. Intramalleolar triplane fractures of the distal tibial epiphysis. J Pediatr Orthop. May-Jun 1997;17(3):352-5. [Medline].

  25. O'Connor DK, Mulligan ME. Extra-articular triplane fracture of the distal tibia: a case report. Pediatr Radiol. May 1998;28(5):332-3. [Medline].

  26. KLEIGER B, MANKIN HJ. FRACTURE OF THE LATERAL PORTION OF THE DISTAL TIBIAL EPIPHYSIS. J Bone Joint Surg Am. Jan 1964;46:25-32. [Medline].

  27. Clement DA, Worlock PH. Triplane fracture of the distal tibia. A variant in cases with an open growth plate. J Bone Joint Surg Br. May 1987;69(3):412-5. [Medline].

  28. Dias LS, Giegerich CR. Fractures of the distal tibial epiphysis in adolescence. J Bone Joint Surg [Am]. Apr 1983;65(4):438-44. [Medline].

  29. Kay RM, Matthys GA. Pediatric ankle fractures: evaluation and treatment. J Am Acad Orthop Surg. Jul-Aug 2001;9(4):268-78. [Medline].

  30. Crawford AH. Ankle fractures in children. Instr Course Lect. 1995;44:317-24. [Medline].

  31. Kärrholm J, Hansson LI, Svensson K. Prediction of growth pattern after ankle fractures in children. J Pediatr Orthop. Jul 1983;3(3):319-25. [Medline].

  32. Brown SD, Kasser JR, Zurakowski D, Jaramillo D. Analysis of 51 tibial triplane fractures using CT with multiplanar reconstruction. AJR Am J Roentgenol. Nov 2004;183(5):1489-95. [Medline].

  33. Whipple TL, Martin DR, McIntyre LF, Meyers JF. Arthroscopic treatment of triplane fractures of the ankle. Arthroscopy. 1993;9(4):456-63. [Medline].

  34. Jennings MM, Lagaay P, Schuberth JM. Arthroscopic assisted fixation of juvenile intra-articular epiphyseal ankle fractures. J Foot Ankle Surg. Sep-Oct 2007;46(5):376-86. [Medline].

  35. McGillion S, Jackson M, Lahoti O. Arthroscopically assisted percutaneous fixation of triplane fracture of the distal tibia. J Pediatr Orthop B. Sep 2007;16(5):313-6. [Medline].

  36. Imade S, Takao M, Nishi H, Uchio Y. Arthroscopy-assisted reduction and percutaneous fixation for triplane fracture of the distal tibia. Arthroscopy. Dec 2004;20(10):e123-8. [Medline].

  37. Phan VC, Wroten E, Yngve DA. Foot progression angle after distal tibial physeal fractures. J Pediatr Orthop. Jan-Feb 2002;22(1):31-5. [Medline].

  38. Butt WP. Triplane fractures of the distal tibia. Orthopedics. Feb 2001;24(2):106. [Medline].

  39. Chin KR, Jupiter JB. Treatment of triplane fractures of the head of the proximal phalanx. J Hand Surg [Am]. Nov 1999;24(6):1263-8. [Medline].

  40. Conroy J, Cohen A, Smith RM. Triplane fracture of the proximal tibia. Injury. Sep 2000;31(7):546-8. [Medline].

  41. Dailiana ZH, Malizos KN, Zacharis K, et al. Distal tibial epiphyseal fractures in adolescents. Am J Orthop. May 1999;28(5):309-12. [Medline].

  42. Dias LS, Giegerich CR. Fractures of the distal tibial epiphysis in adolescence. J Bone Joint Surg Am. Apr 1983;65(4):438-44. [Medline].

  43. El-Karef E, Sadek HI, Nairn DS. Triplane fracture of the distal tibia. Injury. Nov 2000;31(9):729-36. [Medline].

  44. Hou GL, Tsai CC, Huang JS. Relationship between molar root fusion and localized periodontitis. J Periodontol. Apr 1997;68(4):313-9. [Medline].

  45. Jarvis JG, Miyanji F. The complex triplane fracture: ipsilateral tibial shaft and distal triplane fracture. J Trauma. Oct 2001;51(4):714-6. [Medline].

  46. Karrholm J. The triplane fracture: four years of follow-up of 21 cases and review of the literature. J Pediatr Orthop B. Apr 1997;6(2):91-102. [Medline].

  47. Karrholm J, Hansson LI, Laurin S. Computed tomography of intraarticular supination - eversion fractures of the ankle in adolescents. J Pediatr Orthop. 1981;1(2):181-7. [Medline].

  48. Kornblatt N, Neese DJ, Azzolini TJ. Triplane fracture of the distal tibia: unusual case presentation and literature review. J Foot Surg. Sep-Oct 1990;29(5):421-8. [Medline].

  49. Mata SG, Ovejero AH, Grande MM. Triplane fractures in the hand. Am J Orthop. Feb 1999;28(2):125-7. [Medline].

  50. Peiro A, Aracil J, Martos F, Mut T. Triplane distal tibial epiphyseal fracture. Clin Orthop. Oct 1981;(160):196-200. [Medline].

  51. Peterson HA. Extra-articular triplane fracture of the distal tibial epiphysis. J Pediatr Orthop. Sep-Oct 1996;16(5):679. [Medline].

  52. Petit P, Panuel M, Faure F. Acute fracture of the distal tibial physis: role of gradient-echo MR imaging versus plain film examination. AJR Am J Roentgenol. May 1996;166(5):1203-6. [Medline].

  53. Rifkin GB, Lomasney LM, Demos TC. Radiologic case study. Triplane fracture of the distal tibia. Orthopedics. Jul 2000;23(7):667, 750-2. [Medline].

  54. Seifert J, Laun R, Paris S. [Value of magnetic resonance tomography (MRI) in diagnosis of triplane fractures of the distal tibia]. Unfallchirurg. Jun 2001;104(6):524-9. [Medline].

  55. Seitz WH, Andrews DL, Shelton ML, Feldman F. Triplane fractures of the adolescent ankle--a report of three cases. Injury. Sep 1985;16(8):547-53. [Medline].

  56. Smekal V, Kadletz R, Rangger C. A new type of triplane fracture in a 19-year-old snowboarder. J Trauma. Jan 2001;50(1):155-7. [Medline].

  57. Spiegel PG, Mast JW, Cooperman DR, Laros GS. Triplane fractures of the distal tibial epiphysis. Clin Orthop. Sep 1984;(188):74-89. [Medline].

  58. Toupin JM, Lechevallier J. [Post-traumatic epiphysiodesis of the distal end of the tibia in children]. Rev Chir Orthop Reparatrice Appar Mot. 1997;83(2):112-22. [Medline].

  59. Van Laarhoven CJ, Severijnen RS, van der Werken C. Triplane fractures of the distal tibia. J Foot Ankle Surg. Nov-Dec 1995;34(6):556-9; discussion 594-5. [Medline].

  60. Vanhoenacke FM, Bernaerts A, Gielen J. Trauma of the pediatric ankle and foot. JBR-BTR. Aug-Sep 2002;85(4):212-8. [Medline].

[ CLOSE WINDOW ]

Keywords

triplane fracture, transitional fracture, ankle fracture, Marmor-Lynn fracture, multiplane fracture, multipart fracture, adolescent tibial triplane fracture, tibial fracture, tibia fracture, tibial epiphysis, tibial growth plate, growth plate, epiphyseal fracture, epiphyseal growth plate, physis, physeal fracture, distal tibia, distal tibial epiphysis, distal tibial metaphysis, tibia, Maisonneuve fibular fracture, distal fibula, proximal fibula, fibula fracture, fibular fracture

[ CLOSE WINDOW ]

Contributor Information and Disclosures

Author

John L Abt, DO, FACEP, FACFE, Clinical Associate Professor and Senior Consulting Staff, Department of Emergency Medicine, Mount Sinai Medical Center of Miami
John L Abt, DO, FACEP, FACFE is a member of the following medical societies: American College of Emergency Physicians, American College of Forensic Examiners, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Coauthor(s)

Vinod K Panchbhavi, MD, FRCS, FACS, Associate Professor, Chief, Division of Foot and Ankle Surgery, Department of Orthopedics, University of Texas Medical Branch School of Medicine
Vinod K Panchbhavi, MD, FRCS, FACS is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American College of Surgeons, American Orthopaedic Foot and Ankle Society, Royal College of Surgeons of Edinburgh, Royal College of Surgeons of England, and Texas Orthopaedic Association
Disclosure: Nothing to disclose.

Medical Editor

John S Early, MD, Foot/Ankle Specialist, Texas Orthopaedic Associates, LLP; Co-Director, North Texas Foot and Ankle Fellowship Baylor University Medical Center
John S Early, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Medical Association, American Orthopaedic Foot and Ankle Society, Orthopaedic Trauma Association, and Texas Medical Association
Disclosure: Zimmer Inc Consulting fee Consulting; Smith Nephew Consulting fee Consulting; AO North America Honoraria Speaking and teaching; Osteotech Consulting fee Consulting; Stryker Consulting fee Consulting

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Samuel Agnew, MD, FACS, Associate Professor, Departments of Orthopedic Surgery and Surgery, Chief of Orthopedic Trauma, University of Florida at Jacksonville; Consulting Surgeon, Department of Orthopedic Surgery, McLeod Regional Medical Center
Samuel Agnew, MD, FACS is a member of the following medical societies: American Association for the Surgery of Trauma, American College of Surgeons, Orthopaedic Trauma Association, and Southern Orthopaedic Association
Disclosure: Nothing to disclose.

CME Editor

Dinesh Patel, MD, FACS, Associate Clinical Professor of Orthopedic Surgery, Harvard Medical School; Chief of Arthroscopic Surgery, Department of Orthopedic Surgery, Massachusetts General Hospital
Dinesh Patel, MD, FACS is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Association of Physicians of Indian Origin, American College of International Physicians, and American College of Surgeons
Disclosure: Nothing to disclose.

Chief Editor

Jason H Calhoun, MD, FAAOS, Chairman, J Vernon Luck Distinguished Professor, Department of Orthopedic Surgery, University of Missouri
Jason H Calhoun, MD, FAAOS is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American College of Surgeons, and American Orthopaedic Foot and Ankle Society
Disclosure: Nothing to disclose.

 
 
HONcode

We subscribe to the
HONcode principles of the
Health On the Net Foundation

All material on this website is protected by copyright, Copyright© 1994- by Medscape.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.