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Osteochondral Defect at Medial Talar Dome: Preferred Treatment?

Discussion in 'Foot Surgery' started by DrGillman, Dec 18, 2006.

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  1. DrGillman

    DrGillman Member


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    To the group:

    How do you treat this condition, found in a middle-aged skiier with history of ankle inversion sprain (years ago), and now with pain mostly when skiing and hitting bumps: (from MRI report) "...osteochondral injury of the medial talar dome...1.5cm focus of diminished T1 signal corresponding to multiple small subarticular cysts seen on the T2-series...adjacent patchy marrow edema inferiorly...overylying chondromalacia." There were no fragments. The tibial plafond is okay. I am not familiar with surgical procedures and do not know about outcomes in this regard. Since his symptoms are mostly when skiing, occasionally when hiking, and usually not during his normal day, I wonder whether surgical consultation is even worth while. Any thoughts on this would be appreciated.

    Thanks,

    Scott
    www.drgillman.com
     
  2. LuckyLisfranc

    LuckyLisfranc Well-Known Member

    Scott

    Open or arthroscopic currettage and drilling of the defect is usually the preferred option, to stimulate fibrocartilage repair.

    I would suggest referral to your local podiatric surgeon who specialises in ankle and rearfoot procedures for an assessment.

    Kind regards

    LL
     
  3. pahomovigor

    pahomovigor Member

    Dear collegue! You faced with Mouchet desease in your practice. Actually this is an aseptic necrosis of the thalar dome. I posesse about 15 observations of similar patients. In your case the operation of mosaicoplasty is indicated.
    Sincerely Yours.
     
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