Osteochondral damage of the talus can occur due to trauma, hormonal disorders, genetic defects, vascular embolism, spontaneous osteonecrosis, and poor force lines of the limb. Stable cartilage blocks have the potential to regain blood flow and heal. In contrast, for unstable osteochondral injuries of the talus, capillaries have difficulty accessing the cartilage mass and ischemic necrosis will occur. Surface softening, fibrosis, and degeneration.
1.Clinical manifestations.
(1) Acute phase.
History of trauma.
Ankle joint pain, swelling, interlocking, popping.
Other combined injuries.
(2) Chronic phase.
Long-term pain and swelling of the ankle joint.
2.CT classification
Stage I: top of the talus is intact with cystic changes below.
Stage II: cystic change into the joint.
Stage III: cystic lesion into the joint with or without displaced bone masses within.
Stage IV: non-displaced bone mass.
Stage V: displaced bone mass.
3.MRI classification
Stage 1: cartilage damage only.
Stage 2a: cartilage injury, subchondral bone fracture, surrounding bone tissue edema.
Stage 2b: same as stage 2a, without surrounding bone tissue edema.
Stage 3: separation of the osteochondral mass but without displacement.
Stage 4: separation and displacement of the osteochondral mass.
Stage 5: formation of subchondral cyst.
4.Treatment
(1) Conservative treatment.
Restriction of exercise, reduction of activity or in protected activity, brace immobilization for several weeks to several months.
(2) Surgical treatment.
The first three surgical treatments can be performed minimally invasively under ankle arthroscopy in our department.