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At least 523 records · Page 29Linked to original sources
PubMed2004

Imaging of the talus.

There are numerous options for imaging talar pathology. Of these, radiography, CT, scintigraphy, and MRI are used most commonly. Advantages and limitations of these techniques should be considered when formulating an imaging algorithm for evaluation of the patient's clinical problem.

Bone Diseases↗
PubMed2004

Management of fractures of the talus: body and head regions.

Talar head and body injuries are not recognized easily and can create significant long-term disability when missed. Careful investigation of any injury about the ankle requires clinical and radiographic examination. A CT scan is extremely helpful in diagnosing and treating these injuries. Displaced fractures require open reduction of the major joint surfaces and internal fixation. Prolonged nonweight bearing and immobilization is the norm. Despite aggressive management, complications that involve avascular necrosis and posttraumatic arthritis to the subtalar and ankle joints occur frequently.

Fracture Fixation↗
PubMed2004

Osteonecrosis of the talus.

Talar osteonecrosis remains partially understood and a clinical challenge. Further research is necessary to elucidate the etiology, pathophysiology, and true incidence of this complex disorder fully. Optimal imaging strategies and staging systems also require further investigation. As our understanding of talar osteonecrosis evolves, so will our ability to treat this disorder promptly and properly.

Diagnosis, Differential↗
PubMed1999

Osteochondral mosaicplasty for the treatment of focal chondral and osteochondral lesions of the knee and talus in the athlete. Rationale, indications, techniques, and results.

New techniques for articular cartilage transplantation have become available recently for traumatic chondral injuries. Applications to the athlete have generated considerable interest in the sports medicine community. The autogenous osteochondral grafting mosaicplasty has been used to treat these injuries in the athlete population for the past six years. The rationale, indications, operative technique, results, and limitations of mosaicplasty in the athlete are presented and discussed.

Adolescent↗
PubMed2002

The talus: sex assessment of prehistoric New Zealand Polynesian skeletal remains.

Prehistoric Polynesian skeletal remains are frequently being recovered in New Zealand due to the increasing pace of urbanisation. Since such material must often be reinterred quickly, it is important that the sex of individuals be determined from the remains in a relatively short time. For this purpose, discriminant function analysis was utilised for sex determination of prehistoric adult New Zealand Polynesian tali (24 males and 27 females). Five measurements were taken and subjected to Statistical Package for the Social Sciences (SPSS) discriminant function analysis. For the discriminant functions derived, accuracy of sex determination ranged from 85.1 to 93.3%. Reduction in error over random assignment by sex ranged from 70 to 87%.

Female↗
PubMed2003

Arthroscopically assisted osteochondral autogenous transplantation for osteochondral lesion of the talus using a transmalleolar approach.

Osteochondral autogenous transplantation for osteochondral lesions of the talar dome is usually performed through a miniarthrotomy approach, and a medial malleolus osteotomy approach is selected if the lesion is located posteromedially. Recently, we used a transmalleolar approach without osteotomy of the medial malleolus to perform osteochondral autogenous transplantation for a lesion located in the posteromedial portion of the talar dome. We report on this technique and discuss its advantages, disadvantages, and indications.

Arthroscopy↗
PubMed1997

Partial necrosis of the neck of the talus treated with arthroscopy.

An unusual case of an area of necrosis on the talar neck of a girl with a 2-year history of gradually increasing pain following an ankle sprain is presented. Initial radiographs were normal but follow-up radiography showed irregularity in the anterior talar neck. A definitive diagnosis was made by magnetic resonance imaging. Arthroscopic removal of a necrotic fragment from the anterior talar neck that was impinging on the tibia relieved her symptoms. Two years after the operation the patient has normal radiographs and full activity.

Adolescent↗
PubMedDate not supplied

Repair of an osteochondral tumor of the talus utilizing a fresh-frozen cadaveric graft.

A case involving a benign osteochondral tumor of the talar dome is presented. Graft considerations are reviewed and some of their specific characteristics are highlighted. Selection of a fresh-frozen cadaveric graft in this case was based on the goal of maintaining articular congruity in the ankle joint. The authors' experience demonstrated that normal joint function can be preserved with this type of graft.

Acquired Immunodeficiency Syndrome↗
PubMed2002

Osteoarticular grafts in the treatment of OCD of the talus: mosaicplasty versus autologous chondrocyte transplantation.

Further advancements in articular cartilage transplantation require an understanding of the anatomy, physiology, biomaterials, biology, and cartilage engineering that are fundamental for better results in joint arthroplasty and cartilage repair. Currently, efforts to induce healing and regeneration of cartilage are being directed toward enhancing the natural potential of cartilage to replace the damaged tissue with cells that can generate cartilage. Mosaicplasty and ACT are carried out in the same way, have similar therapeutic indications, and have been demonstrated capable of reconstructing hyaline cartilage with similar clinical results. ACT is the most recent technique and, in the authors' opinion, is preferable in that it is less invasive at the donor site and gives better histologic results because of the reconstruction of a continuous cartilage sheath compared with that achieved by mosaicplasty. Furthermore, with this technique, it is possible to forecast the possibility of improvement owing to further technical and biologic advancements. The authors are currently experimenting with the use of adhesive patches with substitution of the periosteum, resulting in less morbidity. The use of growth factors and new tissue engineering techniques in the future would simplify the methodology, rendering it less invasive and more effective.

Animals↗
PubMed2003

Arthroscopic debridement and drilling of osteochondral lesions of the talus.

Diagnosis of OLTs requires a high index of suspicion because these lesions are rare and the symptoms can be falsely attributed to acute or chronic ankle sprains. When no abnormality is present on plain radiographs, a bone scan or MRI can reliably identify the presence of an OLT. CT scanning can provide even better detail of the location and size of the fragment and help stage these lesions and guide treatment. Arthroscopic staging is believed to be the best method to determine treatment. In a patient without an obvious loose body, initial nonoperative treatment is warranted. When nonoperative therapy fails or when a high stage lesion is present, operative options should be explored. Arthroscopic techniques provide results that are equal to or better than management by arthrotomy and have the advantages of lower morbidity and quicker overall rehabilitation time. In most cases, arthroscopic treatment involves loose body removal and debridement and drilling of the underlying bone or drilling alone for intact lesions. Although it is unknown whether such treatment can reduce the incidence of late arthrosis in a patient who has an OLT, a recent study suggested that healing occurs and the MRI appearance of the talar dome normalizes in many patients postoperatively.

Ankle Joint↗
PubMedDate not supplied

[Computer-assisted retrograde drilling of osteochondritic lesions of the talus with the help of fluoroscopic navigation].

AIM: Due to the narrow access to the talar dome and the proximity of osteochondritic lesions to the joint surface, the therapeutic retrograde drilling often requires multiple attempts and repeated intraoperative X-ray-control. The advantages of a fluoroscopy-based computer-assisted navigation system regarding efficient planning and easy performance of the ideal drill path are evaluated in respect to accuracy and radiation exposure, as well as to time requirements. METHOD: A 5 mm spherical target was subcortically implanted in the medial aspect of the talar dome of 16 human cadaver specimens. Free-hand drilling was performed using the FluoroNav TM system in one group and conventional repetitive C-arm control in the other. The computed evaluation of the operative results was realized in a CT-generated 3D-model with the help of the DISOS planning and calculation program. The distance of the tip of the drill to the center of the lesion was measured, as well as X-ray exposure and total operating time. RESULTS: The CAS procedure missed the lesion only once. The mean deviation of the computer-guided drill path was measured to be 2 mm, whereas the conventional method led to a mean distance of 5 mm from the target. Conventional drilling failed to reach the target in 5 cases, violating the articular cartilage twice. Navigation reduced the traditionally required multiple attempts of the intervention to just one drill canal and reduced radiation time to 25 %. Despite the increased technical preparation required, the navigated procedure only exceeded the conventional operating time by 2 minutes. CONCLUSION: Thanks to the significantly increased accuracy, fluoroscopic navigation offers a high degree of safety and efficacy for this minimally invasive procedure. The operation can easily be performed successfully causing only minimal collateral damage to the bone, preserving the joint surface. The inherent risks of the retrograde drilling of osteochondritic lesions are lower with navigation, while the radiation exposure of the patient and the staff is significantly reduced.

Cadaver↗