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At least 163 records · Page 9Linked to original sources
PubMed1997

[Apropos of a case of chondromyxoid fibroma of the talus. A review of the literature].

PURPOSE OF THE STUDY: Chondromyxoid fibroma (CMF) is a very rare tumor. CMF represents less than 1p. 100 of all benign osseous tumors. The upper part of the tibia is the most frequent localization. We report the second case of talus tumor published in the world literature. MATERIAL AND METHODS: A 20 years old man presented a lytic tumor of the talus. The histology diagnosed a Chondromyxoid fibroma. A complete excision was made. An autologous bone graft associated with blocks of coral were used for reconstruction. RESULTS: After six months sport activities were authorized. After 10 years follow-up, there is no recurrence, the coral has progressively disappeared, replaced by host bone. DISCUSSION: Only one case of talus tumor has been published in world literature. Feldman has collected 189 cases of CMF published before 1970. After 1970, 297 new cases published. Analysis of these 486 cases pointed out the frequency of differents localizations. CONCLUSION: This very rare tumor frequent between 10 and 30 years of age. The foot is the second localization after the tibia. A surgical conservative treatment with complete excision is recommended even in case of recurrence. Radiotherapy must be avoided in any case because of the risk of malignant degeneration.

Adult↗
PubMed1998

Dislocated fractures of the talus treated with biodegradable internal fixation.

Six patients with a displaced fracture of the neck or body of the talus were treated using biodegradable screws and rods. During an average follow-up time of 24 (range, 18-31) months, there were no redisplacements nor collapses due to avascular necrosis. All the fractures united. The functional result was mainly dependent on the presence or absence of other injuries, being excellent in 4, good in 1 and poor in 1 patient who also had bilateral highly comminuted calcaneal fractures. Thus, biodegradable implants seem to be suitable for the fixation of displaced fractures of the talus.

Adult↗
PubMed1998

Fracture of the posterior body of the talus--the hidden fracture.

Fractures of the entire posterior process of the talus are rare and may be easily missed. Both the ankle joint and the subtalar joint are involved. This leads to malunion and early degenerative changes. We describe four patients with fractures of the posterior process of the talus which were initially missed. The patients were treated conservatively, and early mobilization or cast immobilization did not change the poor late results. The pitfalls in the diagnosis and imaging evaluation of such fractures are discussed.

Adult↗
PubMed1984

[Primary and secondary arthrodeses following talus fractures].

In 18 cases out of 55 patients, who had been operated on talus fractures in our clinic, a primary or secondary arthrodesis of one or both adjacent joints had been necessary. We carried out a follow-up examination on those 18 patients. In 4 cases a primary or early secondary arthrodesis had been performed; the attempt to reconstruct the joint surfaces after the trauma would have been not promising. The indication of the secondary arthrodesis in the 14 patients is discussed. In all the patients there had been a bony healing of the arthrodesis in an adequate time, the gait pattern of the patients had been improved and they complained less pain. We conclude that in case of a not solvable complication after talus fracture like destroyed joint surfaces, secondary severe arthritis or bone necrosis early secondary arthrodesis should be considered as a measurement to avoid long periods of insufficient conservative treatment.

Adult↗
PubMed2005

Surgical correction of the true vertical talus deformity.

OBJECTIVE: Correction of skeletal deformity and restoration of muscle balance for the improvement of form and function of the foot. INDICATIONS: Developmental vertical talus deformity (idiopathic form). Vertical talus in a developmental arthrogryposis multiplex or in neurologic diseases such as cerebral palsy or spina bifida. CONTRAINDICATIONS: Serious illnesses preventing anesthesia. SURGICAL TECHNIQUE: Achilles tendon lengthening. Release of contracted parts of ankle capsule, of the talonavicular and the calcaneocuboid joints. Reduction of the hindfoot bones and fixation with Kirschner wires. Augmentation of the spring ligament. Further stabilization by an anterior transfer of the tibialis posterior tendon and a posterior transfer of the tibialis anterior tendon. In addition, in instances of severe deformities or inadequately treated feet before surgery, lengthening of extensor tendons and repositioning of anteriorly displaced peroneal tendons. For paretic feet transfer of the peroneus brevis tendon to the tendon of the peroneus longus or in instances of paralysis of the supinators transfer to the tendon of the tibialis posterior. RESULTS: This procedure was done in 74 feet of 45 patients. Follow-up of 59 feet in 35 patients after an average of 7 years and 3 months. At the time of surgery the youngest patient was 6 months old and the oldest 25 years and 6 months (average 4 years and 6 months). Assessment of results using the parameters of Walker et al. An average of 12.5 out of 16 points was reached. The loss of function was mostly due to the underlying diseases such as arthrogryposis, spina bifida or cerebral palsy. One pin site infection, one osteomyelitis, one pressure sore in the cast, and five wound healing disturbances were observed.

Adult↗
PubMed1998

[Functional outcome of surgical therapy of talus fractures].

Forty-five patients with fractures of the talus were treated operatively at the Department of Surgery in Bergmannsheil Hospital between 1989 and 1995. Of these, 21 patients were operated on the day of the accident. The Marti/Weber classification system was used: 9 fractures were type I, 12 type II, 18 type III and 6 type IV. Twenty-five neck-fractures were classified according to Hawkins (type I-6, type II-10, type III-6, type IV-3). The mean time of follow-up was 37.3 months (minimum of 12 months). One patient needed a primary and 2 other patients a secondary arthrodesis of the ankle and subtalar joint; 2 others required arthrodesis of the talonavicular joint. Eleven patients showed no complaints at follow-up. Twenty-five reported complaints only during strenuous exercise, 5 others during walking and 3 patients reported initial pain when walking. The mean time of therapy was 22.5 weeks. As a consequence of trauma, 7 patients changed their jobs. The most important prerequisites for successful surgery are early reduction and stable osteosynthesis. Residual complaints are frequently seen. The rate of avascular necrosis (8% in fractures of the neck of the talus) and the necessity for arthrodesis was significantly diminished.

Adolescent↗
PubMed2002

[Treatment of rare talus dislocation fractures. An analysis of 23 injuries].

METHODS: Between 1980 and 1996 we treated 23 patients for dislocated fractures of the talus. The injury was caused by a car accident in 61% and a high fall in 22%. Five patients had open wounds (22%), two developed compartment syndrome of the foot (9%) at an early stage, and 11 patients had multiple injuries. We used the classifications of Hawkins and Marti/Weber. All fractures were surgically treated by fixation with screw osteosynthesis, percutaneous wire transfixation, and/or external fixation. Fifteen patients with dislocated fractures of the talus underwent clinical and radiological follow-up examinations using the Kiel score. RESULTS: Four patients had excellent and three good results. In five patients with moderate, two with adequate, and one with poor results, we found additional injuries to the ipsilateral foot or leg in 50%. Of those patients, 73% developed peritalar arthrosis and 39% talar necrosis. Due to bony defects, anatomical reconstruction was unsatisfactory in 48%. CONCLUSIONS: Even immediate anatomical reduction and sufficient stabilization cannot always decrease the rate of talar necrosis and peritalar arthrosis.

Adult↗
PubMed2003

[Navigated Iso-C(3D)-based drilling of a osteochondral lesion of the talus].

Retrograde drilling of osteochondral lesions has obtained acceptable results in the initial stage. Intraoperatively not all lesions are accessible with the arthroscopic technique, despite being readily identifiable with modern imaging preoperatively. As an alternative, open surgical treatment is recommended to achieve good results. The use of computer-assisted navigated retrograde drilling of osteochondral lesions has been described with promising results as a new technique. Computed tomography (CT)- and fluoroscopy-based navigation systems in current use are limited in their flexibility. The drawbacks of fluoroscopy are lack of three-dimensional imaging intraoperatively. CT-based navigation still requires intraoperative cumbersome registration, extra preoperative planning, and imaging with further technical resources. In the current case report, we describe a patient with an osteochondral lesion of the posteromedial talus. In addition to the current method of arthroscopic evaluation and treatment, we also introduce an alternative technique of using Iso-C(3D)-based navigation-assisted retrograde drilling of the lesion. The advantages of this technique are an actual intraoperative three-dimensional imaging for the use of navigation without the need for anatomical registration and an immediate postoperative control of surgical treatment. The results of this case report demonstrate accurately navigated drilling with the described system. The accuracy was confirmed with immediate intraoperative Iso-C(3D) and postoperative CT scans. Our results indicate that the use of an Iso-C(3D) navigation system is a possible alternative to arthroscopic or open drilling for osteochondral lesions of the talus. To provide further evidence for the use of Iso-C (3D)-based drilling, current studies will start at our institution.

Adult↗
PubMed2001

[Comparative study of the quality of C-arm based 3D imaging of the talus].

Malposition of extraosseous or intra-articular screws, e.g., in osteosyntheses of joint fractures or in the vicinity of joints, frequently remains undiscovered in intraoperative fluoroscopy and is only recognized on postoperative computed tomography (CT) scans. The aim of the study, therefore, was to assess the value of a new mobile C-arm three-dimensional imaging device in comparison with fluoroscopy, conventional radiographs, and CT scans using an extremity model. Screws were inserted ventrally in four anatomic lower leg specimens without talus fractures parallel to the longitudinal axis to simulate surgical management of fractures of the talus. The specimens supplied were examined with fluorscopy, conventional radiography, spiral CT, and the new three-dimensional imaging with the SIREMOBIL Iso-C3D. These four modalities were evaluated by ten radiologists and ten trauma surgeons and were compared regarding subjective image quality and position of the screws. The quality of information acquired with the SIREMOBIL Iso-C3D was equal to that of the CT examinations, although image quality was considered inferior to fluoroscopy, conventional radiography, and CT (p < 0.001). In contrast to the previous procedure with intraoperative fluoroscopy and subsequent postoperative X-ray control, the results obtained with the SIREMOBIL IsoC3D were superior. The SIREMOBIL Iso-C3D is useful for the intraoperative diagnosis of small joints with few artifacts producing osteosynthesis material, i.e., for recognizing the position of screws in the region of glenoid surfaces.

Bone Screws↗
PubMed2001

[Diagnostic imaging of acute and chronic osteochondral lesions of the talus].

Acute fractures involving the articular surface of the talus run parallel to the surface and are confined to the cartilage and/or the immediate subchondral cancellous bone. Subchondral microfractures ("bone bruises"), osteochondral fractures and solely chondral fractures are different manifestations of impaction injuries that affect the articular surface. This article reviews the radiologic appearance of acute osteochondral lesions of the talus and comments on the role of the noninvasive imaging modalities. Conventional radiography and MRI provide the most relevant information and are widely discussed. A MRI classification is presented emphasizing the distinction between lesions with intact and disrupted cartilage. Osteochondrosis dissecans (OCD) is a chronic osteochondral lesion. It is diagnosed in most cases by conventional radiography. MRI has become a decisive tool in staging the lesions. Intact cartilage and contrast enhancement of the lesions are findings of MRI stage I. Cartilage defects with or without incomplete separation of the fragment, fluid around an undetached fragment, cysts larger than 5 mm in diameter and a dislodged fragment are MRI findings observed in stage II and operative treatment has to be considered.

Ankle Injuries↗
PubMed2001

[Treatment strategies in osteochondral lesions of the talus. Review of the literature].

The aim of this study was to compare the results of different treatment strategies for osteochondral defects (OCD) of the talus. Electronic databases from 1966 to June 2000 were systematically screened. Thirty-nine studies fulfilled our inclusion criteria. No randomized clinical trials could be identified. The results of nonoperative treatment were described in 14 studies, of excision alone in 4, of excision and curettage in 10, of excision, curettage and drilling in 21, of cancellous bone grafting in 2, of fixation in 3, and of osteochondral transplantation in 1. Good or excellent results were found in 45% of the cases. Comparison of different surgical procedures showed that excision, curettage and drilling resulted in the highest mean success rate (86%), followed by excision and curettage (76%) and excision alone (38%). From the results of this systematic review we conclude that nonoperative treatment and excision alone are not to be recommended for treatment of talar OCD. Excision, curettage and drilling produced a high percentage of good or excellent results. Further randomized, controlled trials are required to compare the outcome of these two surgical strategies for OCD of the talus.

Ankle Injuries↗
PubMed2003

Arthroscopic removal of the osteoid osteoma on the neck of the talus.

Juxta-articular osteoid osteomas arising around the ankle are unusual. Tumors arising on the neck of the talus will commonly produce symptoms mimicking monoarticular arthritis or trauma. Patients are usually treated for arthritis or ankle sprain, which often leads to a delay in definitive diagnosis. We present an arthroscopic removal of an osteoid osteoma on the neck of talus, and review the literature.

Adult↗
PubMed2005

Painful nonunion of fracture of the entire posterior process of the talus: a case report.

We report a 14-year-old boy in whom isolated nonunion fracture of the posterior process of the talus. He underwent surgical repair with Herbert Whipple screw fixation and plaster immobilization. Osseous union was achieved 3 months after surgery, resulting in the resolution of symptoms and complete functional recovery. To our knowledge, the present report is the first to describe a successful outcome for surgical treatment of painful nonunion of fracture of the entire posterior process of the talus.

Adolescent↗
PubMed1982

The role of intraosseous phlebography in the prognosis of injuries of the talus.

Fracture-dislocations of the talus are often followed by avascular necrosis. In these cases weight bearing must be forbidden in order to prevent collapse of the talus. Experience with intraosseous phlebography in 31 cases and a 2- to 6-year follow-up in 25 of them showed that this is a useful diagnostic procedure in the assessment of the talar blood supply, and an important aid in deciding the necessary period of relief from weight bearing as well as giving a prognosis.

Adult↗
PubMed1984

The inverted Y approach to the talus and ankle joint.

A case of a comminuted fracture of the body of the talus and the medial malleolus is reported. The inverted Y approach was used to expose the talus and ankle joint, facilitating reduction and internal fixation.

Adolescent↗
PubMed1979

Tuberculous osteitis of the talus.

A case of tuberculous osteitis of the talus in a 6-year-old white male is reported. Osteitis of the talus is uncommon and tuberculous disease of this bone is now rare. There was a delay of 5 weeks between presentation and final diagnosis and the reasons for this delay are discussed. Further investigation showed the presence of tuberculosis of the fifth lumbar vertebra and of the left kidney. With prompt chemotherapy and early surgery, the long term results of this once crippling disease are now excellent.

Child↗
PubMed1991

Age-related changes in the tensile properties of human articular cartilage: a comparative study between the femoral head of the hip joint and the talus of the ankle joint.

Specimens of articular cartilage from the superficial and mid-depth zones of the human femoral head and the talus of the ankle joint were tested in tension in planes parallel to the articular surface and parallel to the predominant orientation of the superficial collagen fibrils. The tensile fracture stress of cartilage from both the superficial and mid-depth zones of the femoral head decreased considerably with age. The superficial zone decreased from 33 MPa at 7 years to 10 MPa by the age of 90 years, while the mid-depth zone decreased from 32 MPa at 7 years to 2 MPa by the age of 85 years. In contrast the fracture stress of both levels of cartilage from the talus of the ankle did not decrease significantly with increasing age. The tensile stiffness at 10 MPa of both the superficial and mid-depth zones of the femoral head decreased with age. That of the superficial zone decreased from 150 MPa at 7 years to 80 MPa at 90 years, while the mid-depth zone decreased from 60 MPa at 7 years to 10 MPa at 60 years. The stiffness of talar cartilage from the superficial zone decreased by 20%, while that of the mid-depth zone showed a slight increase in stiffness at 10 MPa with increasing age. There was no significant decrease in the tensile stiffness at 1 MPa with age for either the femoral head or talar cartilage. Based on the results of previous studies it is possible to conclude that the decrease in tensile properties seen in the femoral head results from a deterioration in the tensile properties of the network of collagen fibrils. It is suggested that progressive fatigue failure, perhaps with associated changes in the structure of cartilage due to altered chondrocyte metabolism, causes the reduction in tensile properties with age. The results offer a potential explanation for the observation that osteoarthritis commonly occurs in the hip and knee joints at an increasing incidence as age increases, while the condition only rarely occurs in the ankle joint except as a secondary event to trauma.

Age Factors↗