Osteochondral lesions of the talus can present as a late complication of ankle injuries. As the talus is largely covered by articular cartilage, it has a limited ability for repair. Early and accurate diagnosis is important as talar integrity is required for optimal function of the ankle. The common presentation is chronic ankle pain with a history of ankle trauma. Conservative treatment involving a period of casting and non-weight-bearing is recommended for acute, non-displaced osteochondral lesions. Surgical management is recommended for unstable lesions or failed conservative management.
Humans ; Osteochondritis ; etiology ; physiopathology ; surgery ; therapy ; Talus ; physiopathology

Adult ; Arthroscopes ; Bone Cysts ; surgery ; Bone Neoplasms ; surgery ; Female ; Humans ; Talus ; surgery

Adult ; Female ; Humans ; Joint Dislocations ; surgery ; Male ; Middle Aged ; Talus ; injuries ; surgery ; Tarsal Bones ; injuries

Fractures of the paediatric talus are infrequent injuries, most complicated by posttraumatic arthrosis and avascular necrosis in the course of treatment. Nonunion in children has not been reported before in literature. We report a case of a 12-year-old boy who had a nonunion of Hawkins type II fracture of talar neck. The nonunion was treated surgically with a good clinical outcome. The goals of management in nonunion of paediatric talar neck fracture are different from those in fresh fractures. A suboptimal reduction should be acceptable without trying a radical surgery which may cause further impairment.
Child ; Fractures, Bone ; surgery ; Fractures, Ununited ; surgery ; Humans ; Male ; Talus ; injuries

Adult ; Bone Cysts, Aneurysmal ; diagnosis ; surgery ; Bone Neoplasms ; diagnosis ; surgery ; Chondroblastoma ; diagnosis ; surgery ; Female ; Humans ; Male ; Talus ; surgery ; Young Adult

Lateral process fractures of talus are rare injuries with a potential to cause significant morbidity if misdiagnosed. The appropriate management of these fractures is still controversial and only a few reports are avai- lable on this subject. We presented a case of a 37-year-old male with neglected fracture on the lateral process of talus which was misdiagnosed at the time of injury. The patient presented to 7 months after misdiagnosis with a chronic ankle pain. Our case is unique in the sense that it is a rare case of neglected fracture on the lateral process of talus which presented as a loose body in sinus tarsi. However, a surgery with an excision of the loose body presented a satis- factory outcome along with 2 years' follow-up. To our knowledge, it ought to be the first case reported in the English literature. Through this case report, we highlight the importance of high index of suspicion for such rare bony injuries while evaluating trauma to the lateral side of ankle and discuss the principles of management of these fractures.
Ankle Fractures ; Ankle Injuries ; surgery ; Ankle Joint ; surgery ; Diagnostic Errors ; Fractures, Bone ; surgery ; Humans ; Joint Dislocations ; Talus ; injuries

Ankle Fractures/surgery* ; Ankle Injuries ; Ankle Joint ; Bone Cysts/surgery* ; Fracture Fixation, Internal ; Fractures, Bone ; Humans ; Talus/surgery*

Child ; Child, Preschool ; Fracture Fixation, Internal ; Fractures, Bone ; surgery ; Humans ; Male ; Talus ; injuries

OBJECTIVETalar fractures present a great challenge to surgeons due to poor treatment outcome and high incidence of sequelae. The purpose of this study was to report the surgical treatment outcome of displaced talar fractures treated by internal fixation.

METHODSA total of 30 patients with a mean age of 38 years presenting with talar body or neck fractures were studied retrospectively to assess postoperative outcome based on American Orthopaedic Foot and Ankle Society Ankle-Hindfoot scale.

RESULTSPostoperatively, malunion was found in 18 cases, infection in 5 cases and avascular necrosis in 12 cases. There were 12 cases with subtalar arthritis and 18 cases with both subtalar and malleolar arthritis. The average score of questionnaire was 64+/-12. Functional score was 53+/-15 and pain score was 65+/-13. Range of motion failure was detected as 15+/-4.

CONCLUSIONTalar injuries can compromise motion of the foot and ankle and result in poor prognosis on long-term evaluation. Late complications subsequent to surgically treated talar body fractures are inevitable, and patients are supposed to be counseled about the adverse outcome.

OBJECTIVETalar body fractures are rare and have poor treatment outcome. The purpose of this study is to report the long term surgical treatment outcome of closed talar dome fractures.

METHODSEight closed talar body fractures, treated by open reduction and internal fixation with small fragment cancellous screws and/or Herbert screws in our level I trauma centre were retrospectively analyzed. Preoperative and postoperative radiographs of the foot (antero-posterior, lateral and oblique views) and ankle (antero-posterior, lateral and mortise views) were obtained. The patients were followed up both radiologically and functionally (foot function index, FFI) after 3 weeks, 6 weeks, 3 months, 6 months and then annually.

RESULTSThere were five crush fractures and three shear fractures (two sagittal shear and one coronal shear), with average follow-up of 5 years. No early complications were noticed in these patients. Late complications included osteoarthrosis of subtalar/ankle joints in six patients and osteonecrosis of talar body in four patients. On functional assessment, mean FFI after 5 years was 104.63 points and worse outcome was noticed in crush injury and coronal shear fractures. Sagittal shear fractures had a good functional and radiological outcome.

CONCLUSIONSLate complications subsequent to surgically treated talar body fractures are inevitable, even though exact reduction and rigid fixation are achieved, thus patients are supposed to be counseled about the adverse outcome. Although crush and coronal shear fractures have poor outcome, sagittal injuries have good prognosis on long term evaluation.