Posteromedial Approach for Osteochondral Lesions of the Talus

TOSUN B.

FOOT & ANKLE INTERNATIONAL, vol.42, no.1, pp.17-22, 2021 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 42 Issue: 1
  • Publication Date: 2021
  • Doi Number: 10.1177/1071100720948842
  • Journal Name: FOOT & ANKLE INTERNATIONAL
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE, SportDiscus
  • Page Numbers: pp.17-22
  • Keywords: ankle, talus, osteochondral, malleolar osteotomy, mosaicplasty, TALAR DOME, TRANSCHONDRAL FRACTURES, TREATMENT STRATEGIES, DISSECANS, ALLOGRAFTS, OSTEOTOMY, EXPOSURE, DEFECTS
  • Kocaeli University Affiliated: Yes

Abstract

Background: Medial malleolar osteotomy is an established procedure for accessing the medial localized osteochondral lesions of the talus. The purpose of this study was to describe a single approach, which allows perpendicular access to the lesion without a malleolar osteotomy. Methods: Six patients were treated surgically for medial localized talar osteochondral lesions. Four patients had stage III and 2 patients had stage IV lesions. A single posteromedial approach was used for accessing the medial talar dome. Results: The method of treatment was mosaicplasty in 4 patients and osteochondral fragment fixation in 2 patients. One patient who was treated with a fragment fixation procedure showed screw loosening. Incorporation of the osteochondral grafts was proved by magnetic resonance imaging in all mosaicplasty cases. Conclusion: A single posteromedial approach was sufficient in the posteromedial localized osteochondral lesion of the talus. As the lesion was approached by soft tissue exposure only, a malleolar osteotomy was not required. Thus, osteotomy-related complications were avoided.