New advances in diagnosis and treatn1ent of osteochondral lesions of the talus

Abstract

Injuries of the talus are si.g..... nifi ca nt because it transmits the body weight from the tibia above to the calcaneus. Also the fact that three fifth of the talus are covered with articular cartilage leads to increased ri sk of

joint involvement with subsequent loss of motion and arthritic changes in ankle. Osteochondral lesions of the talus are those affecting the cartilaginous cover and the subchondral bone. Most of the lesions are traumatic m etiology. The mechanism of injury in lateral lesions is forced inversion with dorsiflexion while forced inversion and plantar flexion cause medial lesions. Diagnosis of the lesions is usually missed in the early

stages. However, plain radiographs can diagnose many of these lesions. When a patient complaints of persistent chronic ankle pa in as well as mechanical symptom, such as crepitus, catching and giving way, together with normal plain radiograph, bone scan is then indicated in order to demonstrate an occult lesion.