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At least 199 records · Page 11Linked to original sources
PubMed2006

Primary talectomy after open total dislocation of the talus: a case report with 13 years follow-up.

Total dislocation of the talus is a rare and severe injury. We report a case of an open total anterolateral dislocation of the left talus with simultaneous contralateral open peritalar dislocation. The former injury was managed with a primary talectomy because of severe contamination and blood supply deprivation. Thirteen years later, the patient complains of mild symptoms on the talectomy side. In contrast, the patient has more serious clinical problems (panarthritis) on the side of the peritalar dislocation.

Adult↗
PubMed1980

Fractures and fracture-dislocations of the neck of the talus.

Forty fractures and fracture-dislocations of the neck of the talus are reviewed. Undisplaced fractures are associated with a high proportion of good results. Type II fractures, where there has been subluxation of the subtalar joint, require accurate reduction to avoid subtalar joint incongruity, and have a 20% incidence of avascular necrosis. Type III fractures, with dislocation of the body of the talus, have a poor prognosis and have a 100% incidence of avascular necrosis. Hawkins' sign of subcortical radiolucency is helpful in ascertaining the presence or absence of avascular necrosis. Accurate open reduction and rigid internal fixation with early range of motion of the involved joints is recommended where a closed reduction has failed to provide anatomic reduction.

Adolescent↗
PubMed2006

Ultrasound: a helpful technique in the analysis of congenital vertical talus. A case report.

Congenital vertical talus is a rare condition. In newborns, the diagnosis is evident in severe forms, but it can be difficult to confirm in mild ones. Non-ossified tarsal navicular cannot be visualized on standard roentgenograms until it is ossified. This work demonstrates that ultrasound is helpful in the early diagnosis of congenital vertical talus and in the evaluation of the therapeutic concept and effects.

Casts, Surgical↗
PubMed1987

Fractures of the lateral process of the talus.

This study is a retrospective review of nine patients who sustained isolated fractures of the lateral process of the talus. The majority were caused by inversion or a combination of inversion and dorsiflexion of the foot. Following a review of the literature and anatomical dissections the authors recommend a classification based on anterior-posterior tomography of the talus, into intra- and extra-articular fractures.

Adult↗
PubMed2001

Unusual osteochondral lesions of the talus in a horse.

A 2-year-old Thoroughbred gelding was evaluated for a grade 3 out of 5 unilateral hind limb lameness. Flexion of the right hock and stifle joints (spavin test) exacerbated the lameness. Response to intra-articular and perineural anaesthesia isolated the source of lameness to the tarsocrural area, despite an absence of tarsocrural joint effusion. Routine radiographic examination of the hock did not reveal any significant abnormalities. Skeletal nuclear scintigraphic evaluation revealed a focal region of increased bone activity in the proximal medial trochlear ridge of the talus. Flexed lateromedial radiographic views identified three discrete semicircular lytic lesions at the proximal articular margin of the medial trochlear ridge of the talus. Conservative management of the lesions was associated with a successful return to racing. The location and appearance of the osteochondral lesions of this report have not been previously reported and may be a manifestation of developmental orthopaedic disease and abnormal endochondral ossification. Nuclear scintigraphy and flexed lateromedial radiographic views facilitated identification of the lesions. This radiographic view is recommended when lameness is isolated to the tarsocrural joint and standard radio-graphic projections fail to identify a cause.

Animals↗
PubMed2003

Fracture of lateral process of the talus presenting as ankle pain.

The case is presented of a 27 year old woman with lateral ankle pain after an inversion injury sustained while dancing. Although initial radiographs failed to identify the fracture, radiographs of the ankle at six weeks showed an unsuspected fracture of the lateral process of the talus. The fracture was treated with cast immobilisation for six weeks and the patient is currently undergoing aggressive physiotherapy. A literature review revealed that fractures of the lateral process of the talus are frequently overlooked and should be considered in the differential diagnosis of patients with acute and chronic ankle pain as an early diagnosis and treatment prevent long term complications.

Adult↗
PubMedDate not supplied

Avascular necrosis of the talus: a pictorial essay.

The talus is predisposed to avascular necrosis (AVN), or bone death due to ischemia, owing to its unique structure, characteristic extraosseous arterial sources, and variable intraosseous blood supply. Both traumatic and atraumatic causes have been implicated in talar AVN. The risk of posttraumatic AVN can be predicted using the Hawkins classification system. In addition, the "Hawkins sign" can be used as a radiographic marker that excludes the development of AVN. At radiography, talar AVN typically manifests as an increase in talar dome opacity (sclerosis), followed by deformity and, in severe cases, articular collapse and bone fragmentation. At any stage of this sequence, the radiographic findings can vary depending on differences in the vascular status of the talus and the degree of bone repair. Magnetic resonance imaging is the most sensitive technique for detecting talar AVN and can be used when AVN is strongly suspected clinically despite normal radiographic findings. Computed tomography (CT) also demonstrates typical patterns and can be used to confirm radiographic findings. Coronal CT is required for viewing the articular surface of the talar dome to rule out subtle depression, collapse, and fragmentation. Nevertheless, radiography remains the mainstay of the diagnosis and temporal observation of talar AVN.

Adolescent↗
PubMedDate not supplied

Primary ankle fusion using blair technique for severely comminuted fracture of the talus.

OBJECTIVE: We report a case of a severely comminuted fracture of the body of the talus treated by primary Blair tibiotalar fusion. CLINICAL PRESENTATION AND INTERVENTION: A very severely comminuted open fracture of the body of the talus was treated on the same day of injury by debridement and tibiotalar fusion using the Blair fusion technique. CONCLUSION: Blair fusion may be indicated in cases of severely comminuted fractures of the talar body. It has the advantage of giving a near-normal appearance to the foot, producing less shortening and allowing motion to remain at the talonavicular and anterior subtalar joints.

Adult↗
PubMed2005

Isolated talus metastasis from breast carcinoma: a case report and review of the literature.

BACKGROUND: Acrometastases are very rare and have been identified in only a few cases on the foot. At the onset, they might be misdiagnosed as arthritis. CASE REPORT: A 59-year-old woman with isolated metastasis to the talus, originating from breast carcinoma was treated by radiotherapy, letrazole, and intravenous bisphosphonates. RESULTS: The review of the literature revealed that this is the first case of an isolated metastasis to the bone of talus from a breast carcinoma, while there are a few cases originating from other organs. The differential diagnosis of acrometastases may be difficult. CONCLUSION: Pain in the foot or hand of a patient with a known history of malignancy should be considered as potential metastasis.

Bone Neoplasms↗
PubMed1984

The role of cartilage canals in the ossification of the talus.

Interrupted serial sections of the foot region from 14 human fetuses, crown-rump (CR) lengths between 32 and 240 mm, were studied, using HE, PAS, Alcian blue, Gomori's trichrome and von Kossa stains. Cartilage canals carrying vascular connective tissue from the perichondrium entered the talus by 68-mm. The centre of ossification developed in the neck region of the talus cartilage by 240 mm CR length, but early stages of chondrocyte proliferation and hypertrophy were noted by 108-mm CR length. The latter is marked by 170 mm CR length. A number of cartilage canals were observed around the developing centre. Branches from these cartilage canals appeared to supply vascular osteogenic tissue to its marrow spaces.

Cartilage↗
PubMed2005

Mosaicplasty with autogenous talar autograft for osteochondral lesions of the talus after failed primary arthroscopic management: a prospective study with a 4-year follow-up.

BACKGROUND: There have been limited data in the literature reporting the results of osteochondral autografting for osteochondral lesions of the talus that have failed arthroscopic treatment. HYPOTHESIS: Osteochondral autografting can produce significant clinical improvement and a high rate of healing of osteochondral defects of the talus that have failed arthroscopic treatment. STUDY DESIGN: Cohort study; Level of evidence, 4. METHODS: Between 1998 and 2003, 35 patients (18 men, 17 women) with osteochondral talar lesions for which arthroscopic excision, curettage, and drilling had failed, underwent mosaicplasty with an osteochondral graft harvested from the ipsilateral talar articular facet. A malleolar osteotomy or a tibial wedge osteotomy was used for central or posterior lesions that could not otherwise be reached. The mean age of the patients was 30.9 years, and the mean follow-up was 48.9 months. RESULTS: The American Orthopaedic Foot and Ankle Society Ankle Hindfoot scale score in patients without osteotomy rose by 39 points (P = .0001); with malleolar osteotomy, by 30.1 points (P = .017); with tibial wedge osteotomy, by 34.9 points (P = .0002); and with the posterolateral approach, by 32 points. The Wilcoxon test revealed a significant difference between patients without and with osteotomy (P <or= .027) and between patients with malleolar and tibial wedge osteotomies (P = .046). There were no patients with nonunion or malunion in the osteotomy groups. The score values corresponded with the subjective patient evaluation. The Spearman coefficient of correlation was .89. CONCLUSION: Osteochondral autografting with tibial wedge osteotomy is a good alternative to malleolar osteotomy in osteochondral talar lesions that have failed arthroscopic treatment and that cannot be reached in spite of a forced plantar flexion of the ankle. Patients with small osteochondral lesions accessible through an anterior approach without additional osteotomy have the best prognostic factors.

Adolescent↗
PubMedDate not supplied

Conditions of the talus in the runner.

The anatomy and biomechanics of the talus in its relationship with ankle and subtalar joints expose it to increased stresses and forces in the runner. Many injuries to the talus, such as stress fractures, anterolateral compression syndromes, osteochondral Stage I and II lesions, and posterior compartment fractures can be treated with consecutive methods initially. Surgical treatment is indicated if these problems become chronic or in the conditions of osteochondral Stage III and IV lesions, anterior impingement syndrome, or symptomatic or trigonum fractures.

Athletic Injuries↗
PubMedDate not supplied

Osteochondral lesions of the talus.

We report demographic, clinical, and imaging data on 92 patients with osteochondral lesions of the talus collected in one center between 1981 and 1992. All patients reported pain as their primary symptom. Ninety-four percent of the patients reported pain with activity. Physical examination was unhelpful. Using newer imaging techniques (bone scan and computed tomography) and with increased awareness, we have observed a sevenfold increase in the diagnostic frequency of osteochondral lesions of the talus between the years 1981 to 1986 and 1987 to 1992. Bone scan is an excellent screening tool for patients with chronic ankle pain and has 99% sensitivity in depicting osteochondral lesions. Computed tomography demonstrated a previously unclassified lesion, the radiolucent defect, which accounts for 77% of the lesions in this series. We have therefore modified the Berndt and Harty classification system, basing it on radiographic appearance (principally computed tomography) and adding the radiolucent lesion. Fifty-eight patients were treated surgically. Anterior and midtalar lesions are now approached arthroscopically. Surgical treatment of the radiolucent lesion, consisting of curettage and drilling, gives 42% excellent and 32% good results. Pain relief often occurs within months of surgery, but healing of the lesion requires years, and some may persist indefinitely.

Adolescent↗
PubMed2000

Follow-up study of MRI for osteochondral lesion of the talus.

Characteristic MRI findings of osteochondral lesions of the talus have been reported. We examined how they change before and after treatment and discussed their significance. Twenty two ankles in 21 patients had MRI examination before and after treatment of the talar lesion. We evaluated the changes in the low intensity areas in T1-weighted image and the signal rims behind osteochondral fragment in T2-weighted image which have been reported as characteristic findings. Clinical symptoms were improved postoperatively in all subjects. The low intensity areas in T1-weighted image seen before the surgical treatment tended to decrease in size postoperatively. The low intensity area in T1-weighted image was reduced in 15 of the 22 ankles (68.2%). Low signal rim in T2-weighted image was seen in three cases before the treatment. All disappeared completely after arthroscopic drilling. Similarly, high signal rim in T2-weighted image seen in 13 cases before the treatment disappeared in 10 postoperatively. These findings were considered indicative that surgical treatments reduced abnormal stress of the underlying bone element due to unstable osteochondral fragment, leading to reduction of the low intensity area. The disappearance of signal rims in T2-weighted images was considered to indicate obliteration of the interface between the osteochondral fragment and the talar bed with bone union. We believe that MRI of the osteochondral lesion of the talus will be useful for postoperative evaluation allowing assessment of the need for further treatment. The decreasing size of low intensity areas in T1-weighted images and disappearance of signal rims behind the osteochondral fragment in T2-weighted images suggested healing of the osteochondral lesions.

Adolescent↗
PubMed2000

Transient osteoporosis of the talus.

Transient osteoporosis is a clinical syndrome of unknown etiology characterized by the acute onset of pain gradually worsening over several weeks to months. Radiographic changes occur, but laboratory studies are generally unremarkable. Transient osteoporosis of the talus appears to have a similar clinical appearance, radiographic findings, and successful response to conservative management as transient osteoporosis found elsewhere in the body and can be treated similarly. Awareness of this syndrome is important to avoid confusing it with a variety of other disorders of the talus that may have similar clinical presentations.

Ankle↗
PubMed2000

Medial impingement syndrome of the anterior tibiotalar fascicle of the deltoid ligament on the talus.

Eleven patients with medial impingement syndrome of the anterior tibio-talar fascicle (ATTF) of the deltoid ligament on the talus were identified. Six sustained inversion injuries, one talus and four ankle fractures. The mean preoperative Ankle-Hindfoot Scale (AHS) was 56 and the postoperative was 87. Surgical debridement of the ATTF was performed. A thickened ATTF and localized synovitis were seen. Talar osteophytes were removed in 8 patients. Mean follow up 4 years. Nine patients had good to excellent results and all patients returned to work.

Adult↗