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At least 289 records · Page 16Linked to original sources
PubMed1975

[Surgically treated malleolar fractures--results after 3 to 4 years under special consideration of the talus profile (author's transl)].

An account is given of 216 cases of fracture of the ankle joint treated with the AO method. 167 patients with 168 fractures could be controlled personally 3-4 years after operative treatment. In 90% we found a good or satisfactory result. The result depends on the anatomical reconstruction of the congruity of the joint and the primary defect of the cartilage. The arthrosis seen in X-rays must not show a bad clinical function. Contrary to the experimental results the form of the talus is not important to the clinical course.

Ankle Joint↗
PubMed1988

Chondroblastoma of the talus: natural development over 9.5 years. Case report.

The spontaneous development of chondroblastoma was seen clinically and demonstrated radiologically in the talus of a 5.5-year-old boy. It was followed for 9.5 years before surgery was performed. Histological examination revealed typical features. This suggests that chondroblastomas may undergo very slow growth and development. The case is compared with 31 other chondroblastomas of the foot.

Adolescent↗
PubMed1981

[Choice of treatment of central talus fractures (author's transl)].

Because of the anatomical and functional peculiarities of the astragallus surgical and conservative treatment of central fractures are often unsatisfactory. A follow-up study of 40 patients with 42 central talus fractures were performed over an average of 9 years after the initial trauma. The number of poor results was extremely high; only primary surgical or conservative treatment showed good or fair results. Best results were obtained by primary surgical treatment whereas fractures operated at later stages showed worse results. Therefore fresh central astragallus fractures should be operated upon, fractures older than 1 day should be treated conservatively. If a satisfactory reduction cannot be obtained, the fracture should be operated upon in order to prevent arthrosis in the upper ankle joint.

Adult↗
PubMed2003

[Visualization of radiographically occult osteochondrosis dissecans of the talus using MRI].

Posttraumatic disorders of the ankle are a common cause of chronic pain. Magnetic resonance imaging (MRI) has proved to be highly useful in clarifying a wide spectrum of underlying lesions which frequently cannot be detected on radiographs. Even if the assessment of the lateral collateral ligaments of the ankle is not regarded as a primary indication for MRI, it allows the diagnosis of subchondral contusions or cysts, anterolateral impingement syndrome, sinus tarsi syndrome, osteochondral fractures and osteochondrosis dissecans of the talus (ODT),which may not be detected with other imaging modalities. A 42 year old female patient suffered from persisting non-specific pain following an inversion trauma 4 months previously. MRI enabled the detection of an ODT which was not diagnosed on plain radiographs and which was verified upon arthroscopy. A superficial cartilage defect, as shown arthroscopically,was not delineated using MRI. Our observations indicate that MRI may be useful in patients with unclear persisting pain following ankle trauma and that it may contribute to the early detection of lesions which require surgical intervention.

Adult↗
PubMed2004

[Microfracture technique for treatment of osteochondral and degenerative chondral lesions of the talus. 2-year results of a prospective study].

The microfracture technique has become an established method for the treatment of chondral lesions in the knee. The aim of this study was to determine its usefulness in the treatment of osteochondral (OCL) and degenerative chondral lesions (DCL) of the talus. In a prospective study, 32 patients with an osteochondral lesion (22 patients) or degenerative chondral lesion (10 patients) were operated arthroscopically and treated with the microfracture technique. All patients were evaluated preoperatively as well as 3, 6, 12, and 24 months postoperatively with the Hannover scoring system and a visual analog score (VAS). MRI scans were performed at all points. Statistical analyses were performed using the Wilcoxon sign rank-sum test with a level of significance of p < or = 0.05. At a mean follow-up of 2 years (range: 22-27 months), 23 patients (14 OCL, 9 DCL) were available for follow-up. The average age of the 17 male and 15 female patients at the time of operation was 39 years (range: 16-74 years). The results according to the Hannover scoring system were 43% excellent, 35% good, and 22% satisfactory with 93% excellent or good results for OCL. Older patients (>50 years, n=8) had slightly better results than younger patients. VAS revealed an average of 7.84 (preoperative: 3.53) for pain, 7.85 for function (preoperative; 3.38), and 7.78 for satisfaction (preoperative: 2.41). MRI and arthroscopic assessment showed a visible regeneration of the cartilage in the microfractured area. In a short-term follow-up, the microfracture technique has proven to restore severe cartilage damage with a good functional outcome. Age is not a limiting factor. However, longer-term results remain to be evaluated.

Adolescent↗
PubMed1999

[Focus debridement of chronic sequestered talus osteomyelitis by TCNC arthrodesis. A new technique with ring fixateur].

A technique utilizing the Ilizarov ring fixator to stabilize a tibio-calcaneo-naviculo-cuboideal arthrodesis following talus resection is introduced. The advantages of this method will be demonstrated with the help of a case history. The described method permits early weight bearing, while supplying stability and compression of the fusion, thereby avoiding further loss of bone stock, while reducing the risk of thromboembolic complications. The Ilizarov ring fixator construction allows for the combination of the fusion with the correction of a preexisting or ensueing leg length discrepancy.

Adolescent↗
PubMed2001

[Approach to open treatment of osteochondral lesions of the talus].

Arthroscopic techniques still represent the treatment of choice in osteochondral lesions of the talus (OLT). Open techniques may be used as an alternative or may be complementary to arthroscopic treatments. They are especially indicated in cases of large osteochondral lesions, difficult localisations and in cases of recurrent interventions. In addition to the type of treatment for the lesion itself, the choice of an ideal surgical approach is of paramount importance. Indications, operative technique, possible complications and rehabilitation are described in detail for each approach. Anterolateral, anteromedial, posterolateral and posteromedial soft-tissue approaches as well as medial and lateral malleolar osteotomies are discussed. If a distraction is not desired with arthroscopy, posteromedial and posterolateral soft-tissue approaches offer a good alternative for the treatment of posterior OLT. Osteotomy of the (medial) malleolus offers good visualisation of the medial talar dome. With the introduction of new techniques of osteochondral transplantations, the use of this approach is becoming more popular. However, it is an invasive technique and the risk of secondary osteoarthritis after malleolar osteotomy still needs to be determined.

Ankle Injuries↗
PubMed2001

[Operative therapy of osteochondral lesions of the talus with autologous cartilage-bone transplantation].

Since 1996 we have gained experience in the development and clinical application of the OATS technique in 167 cases. Operative management, technical demands and early results of osteochondral cylindrical autograft plugs at the talus are presented. Between April 1996 and November 2000 we treated 39 patients (21 male, 18 female) with an average age of 28.4 years (range: 16-57 years) for osteochondral defects with an average size of 8 x 15 mm-20 x 15 mm at the medial (n = 31) and lateral (n = 6) talar dome as well as at the distal tibia (n = 2) with an OATS technique. Indications were osteochondral defects after trauma in 12 patients (med., n = 5; lat., n = 5; dist. tibia n = 2) and osteochondrosis dissecans (grades III and IV) in 27 patients (med., n = 26; lat., n = 1). The donor site was the proximal lateral femoral condyle in all patients. An additional osteotomy of the malleolus was necessary in 30 patients. All patients were scored pre- and postoperatively by a Lysholm Bruns score and monitored by postoperative MRI. The follow-up extended for an average of 19.6 months (6-42). The Lysholm score for all patients rose from 62 points (range: 20-77) up to 92 points (range: 63-100). There was no correlation between patients with and without an osteotomy of the malleolus. The postoperative MRI showed a complete incorporation and vitality of the transplanted cylinders as well as a congruence of the joint surface. Complications were pain in three cases in the region of the osteotomy, which decreased after removal of the screws, and synovialitis in one case. One patient reported femoropatellar pain for about 4 weeks. The OATS technique achieves encouraging results in limited osteochondral defects in the talar dome even in preoperated osteochondral defects. Because of the mostly posterior localization of the defect zone, osteotomy of the malleolus is necessary in most cases. Harvesting the donor cylinders from the ipsilateral knee joint by mini-arthrotomy shows a low mortality. The OATS technique is a suitable, causal and cost-effective therapy, which can possibly prevent and at least delay the development of an arthrosis.

Adolescent↗
PubMed2001

[Computer-assisted retrograde drilling of osteochondral lesions of the talus].

Treatment principles of osteochondral lesions of the talus usually consist of debridement of the chondral part and methods that attempt to stimulate revascularization of the necrotic bony part of the lesion. The latter is mostly achieved through multiple drilling of the subchondral zone. Dorsomedial talar dome lesions are frequently inaccessible with antegrade drilling techniques. In addition, if the cartilage surface over the bony lesion is still intact, it can be injured by antegrade drilling. To overcome these potential problems, retrograde drilling techniques have been developed using drill guides or intraoperative fluoroscopy. Our proposed method of computer-assisted retrograde drilling is an advancement of these techniques. The use of 3D navigation provides the possibility for placing a guide wire exactly in the center of the lesion defined on preoperative MRI or CT scans. This guide wire can then be overreamed with cannulated reamers followed by retrograde bone grafting of the lesion or allows multiple retrograde drilling of the subchondral plate using a parallel drill guide. We found that computer-assisted retrograde drilling could improve precision, avoid misplacement of guide wires, and reduce the time of surgery and intraoperative fluoroscopy.

Arthroscopy↗
PubMed2004

A solitary lesion of talus with mixed sclerotic and lytic changes: Rosai-Dorfman disease of 25 years' duration.

Rosai-Dorfman disease (sinus histiocytosis with massive lymphadenopathy) is an unusual form of histiocytic disorder predominantly affecting children and young adults. Bone lesions are infrequent. We describe a 63-year-old woman with a solitary lesion of the talus which was misdiagnosed for 25 years. The patient never had adenopathy or other organ involvement. The radiographic findings were a mixture of sclerotic and lytic changes, an extremely rare and unusual presentation of the disease.

Female↗
PubMed2004

Congenital vertical talus in four generations of the same family.

OBJECTIVE: This paper presents four generations of a family with radiographically demonstrated congenital vertical talus (CVT) in whom a HOXD10 gene mutation was identified. Some members of the family with this mutation exhibited cavo-varus foot deformity consistent with a Charcot-Marie-Tooth (CMT)-like disorder. DESIGN AND PATIENTS: Physical examination was performed on nearly all of the affected and unaffected family members. DNA was extracted from blood obtained from 14 subjects who showed radiographic and clinical features of CVT (two of whom also had CMT), from two subjects with features of CMT but not CVT, and from 20 related family members who were clinically normal. RESULTS: Radiographs show the appearance of uncorrected CVT in infancy, in childhood, and in adulthood. DNA analysis revealed a mutation in a HOXD10 gene located on chromosome 2 in all of the affected but none of the unaffected family members. CONCLUSION: There is an autosomal-dominant-inherited mutation with complete penetrance which is found in all members of a pedigree with CVT, some of whom exhibit a CMT-like foot disorder. Radiologic findings vary depending on the severity of involvement, treatment provided and age of the patient.

Adolescent↗
PubMed1998

Recurrent parosteal osteosarcoma of the talus in a 2-year-old child.

Parosteal osteosarcoma is an uncommon, low-grade malignant bone tumor and is found in an older age group than conventional osteosarcoma. We present a talar parosteal osteosarcoma that recurred twice in a 2-year-old child. To our knowledge, this is the youngest patient reported with a parosteal osteosarcoma. The talus is an unusual site for parosteal osteosarcoma. Inadequate resection due to a diagnosis of juxtacortical chondroma resulted in recurrence of the tumor. The age of the patient, the thick cartilaginous cap, and well-differentiated trabecular bone all contributed to the critical erroneous diagnosis.

Bone Neoplasms↗
PubMed1999

Fracture of the lateral process of the talus: appearance at MR imaging and clinical significance.

The case of a 59-year-old man with chronic lateral ankle pain following an inversion injury is presented. MR imaging performed to evaluate for soft tissue injury revealed an unsuspected fracture of the lateral process of the talus. The patient underwent surgical exploration of the fracture with debridement of adjacent loose bodies and is currently undergoing aggressive physical rehabilitation.

Fractures, Bone↗
PubMed1986

Fractures of the talus and calcaneus: evaluation by computed tomography.

Fractures of the talus and calcaneus may be difficult to evaluate using conventional imaging modalities. Failure to recognize these fractures or to appreciate their extent may result in severe deformity or disability. Patients with talar and calcaneal fractures had computed tomography to assess its role in the management of these fractures. Computed tomography is superior to other imaging modalities in showing the position of the fracture fragments, the number of fragments, the relation of the fracture to the articular surfaces, residual articular changes, and evidence of healing.

Calcaneus↗
PubMed2006

Osteochondral lesions of the talus: randomized controlled trial comparing chondroplasty, microfracture, and osteochondral autograft transplantation.

PURPOSE: The purpose of this study was to compare outcomes of chondroplasty versus microfracture versus osteochondral autologous transplantation (OAT) in patients with osteochondral lesions of the talus (OLT). METHODS: After prospective sample size analysis, patients with symptomatic, recalcitrant Ferkel class 2b, 3, and 4 OLT were randomized to chondroplasty, microfracture, or OAT treatment groups. Outcomes were measured with use of the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale (AHS), the Subjective Assessment Numeric Evaluation (SANE) rating, Numeric Pain Intensity (NPI), and magnetic resonance imaging (MRI). RESULTS: Eleven patients had chondroplasty, 10 ankles (9 patients) had microfracture, and 12 patients had OAT. Mean time to follow-up was 53 months (range, 24 to 119 months). AHS scores showed no differences at 12 and 24 months, and SANE ratings showed no differences at final follow-up. NPI was significantly lower (P < .001) in chondroplasty and microfracture cases as compared with OAT at 24 hours postoperatively. Pearson's correlation analysis demonstrated an inverse relation between microfracture and OAT groups in that better outcome was associated with smaller lesions, compared with the chondroplasty group, which revealed mixed results with no particular trend. MRI revealed incomplete fill and edema after chondroplasty or microfracture and chondral gaps after OAT. CONCLUSION: Our results demonstrate no difference between chondroplasty, microfracture, and OAT with regard to AHS and SANE ratings in patients with OLT. However, NPI at 24 hours postoperatively was significantly lower in patients who had chondroplasty and microfracture. LEVEL OF EVIDENCE: Level I, Therapeutic study, high-quality randomized controlled trial with no statistically significant differences but narrow confidence interval.

Adolescent↗
PubMed2004

Surgical approaches to the talus.

Surgical approaches to the talus should allow access for fracture fixation, resection of osteophytes, treatment of osteochondral lesions, removal of painful os trigonum, and resection of hindfoot coalitions. This article describes the specific approaches to these conditions as well the structures at risk during surgery.

Ankle Joint↗