scholarly journals Iatrogenic Osteochondral Kissing Lesion After Transmalleolar Drilling of the Talar Dome

2009 ◽  
Vol 99 (1) ◽  
pp. 54-57 ◽  
Author(s):  
Pieter D’Hooghe ◽  
Kevin Deschamps ◽  
Giovanni Matricali

Ankle injuries can lead to early osteoarthrosis when diagnosis is delayed. The clinical presentation of an osteochondral lesion of the talar dome is often difficult to diagnose in the initial setup of an ankle sprain or fracture. Once the lesion is adequately imaged and staged, open or arthroscopic treatment can be initiated. We discuss the arthroscopic treatment of a posteromedial talar dome lesion in this case report. Transmalleolar drilling was performed to treat an osteochondral lesion of the talar dome in a 24-year-old female. Her ankle evolved toward a severe clinical and radiologic condition in which a combined talar and tibial (kissing) lesion was seen during her follow-up. Therefore, we recommend the use of retrograde drilling or arthroscopic microfracture with minimal iatrogenic risk, instead of transmalleolar drilling, as the treatment of choice in these specific osteochondral lesion of the talar dome cases. (J Am Podiatr Med Assoc 99(1): 54–57, 2009)

2005 ◽  
Vol 95 (1) ◽  
pp. 91-96 ◽  
Author(s):  
Scott C. Nelson ◽  
Darryl M. Haycock

Traumatic ankle conditions can lead to long-term sequelae if a pathologic process is misdiagnosed. The clinical presentation of an osteochondral lesion of the talar dome requires the clinician to have a high index of suspicion, and advanced imaging is often necessary to make the final diagnosis. Treatment should be initiated once the lesion is appropriately staged by radiologic or magnetic resonance imaging. We discuss the use of arthroscopy-assisted retrograde drilling of the medial talar dome that spares the articular cartilage within the talotibial articulation. (J Am Podiatr Med Assoc 95(1): 91–96, 2005)


2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0003
Author(s):  
Yasunari Ikuta ◽  
Tomoyuki Nakasa ◽  
Yusuke Tsuyuguchi ◽  
Yuki Ota ◽  
Munekazu Kanemitsu ◽  
...  

Category: Ankle, Arthroscopy Introduction/Purpose: Osteochondral lesion of the talar dome (OLT) is common condition that causes pain of ankle joint in juvenile patients. Several surgical options have been available such as excision of detached cartilage fragment, microfracture, autologous cancellous bone graft and osteochondral autografting depending on the status of OLT. Arthroscopic drilling including transmalleolar or retrograde technique could be a good option for OLT patients with stable osteochondral fragment with normal articular surface. Retrograde drilling has an advantage in preventing the iatrogenic articular cartilage injury. This study aimed to clarify the clinical outcome of the retrograde drilling for OLT in juvenile patients. Methods: Our retrospective analysis included 8 patients who underwent retrograde drilling for OLT, in 5 boys and 3 girls, with a mean age of 14.9 years (range, 11-19). Range of motion (ROM) and American Orthopaedic Foot & Ankle Society (AOFAS) ankle- hindfoot score were evaluated as the clinical outcomes. OLTs were classified into 4 grades according to arthroscopic findings by international cartilage research society (ICRS) classification. Radiographic analysis was performed using preoperative and postoperative images. Growth plate was evaluated on plane radiographs, and the location and size of OLT were assessed on computed tomography. The high intensity area of the talus was also measured on T2 fat suppression images. Results: All 8 patients were followed with a mean follow-up period of 2 years, and they had no complication or revision surgery. The mean total ROM were 65.6° preoperatively and 67.1° postoperatively. AOFAS scale improved from 69.3 to 96.7 (p = 0.012). The ICRS 1 and 2 OLT lesions were identified arthroscopically in 5 and 3 patients, respectively. Growth plate remained open in 4 patients, and OLTs were located on the posteromedial in 7 patients, center in 1 patient. The mean size of OLT fragment was 9.8 mm, 6.8 mm and 3.5 mm in length, width and height. Coronal and sagittal T2 fat suppression images demonstrated that the high intensity area of 241.3 mm2, 554.5 mm2 at preoperative status and 190.9 mm2, 302.6 mm2 at final follow-up status. Conclusion: These findings revealed that the retrograde drilling remarkably improved clinical status in juvenile OLT patients. The high intensity area at the talus remained postoperatively, however, that did not affect clinical results. Retrograde drilling procedure should be considered for treating juvenile patients in the early period after detection of the OLT.


2014 ◽  
Vol 1 (1) ◽  
pp. 34-37
Author(s):  
A Patel ◽  
J Mangwani ◽  
W Al-Jundi ◽  
A Askari ◽  
D Moore

ABSTRACT Osteochondral lesions of the talar dome are well described. To our knowledge, there are no published reports of osteochondral lesion of the talar head. We report the case of a 16-year-old girl who presented with a nontraumatic osteochondral lesion of talar head, which was treated with arthroscopic debridement and bone marrow stimulation. At 6-month follow-up, the patient was symptom free and the radiograph showed signs of healing of the lesion. How to cite this article Mangwani J, Patel A, Al-Jundi W, Askari A, Moore D. Nontraumatic Osteochondral Lesion of the Talar Head: A Case Report and Description of Operative Technique for Arthroscopic Debridement. J Foot Ankle Surg (Asia-Pacific) 2014;1(1):34-37.


2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Alessandro Casiraghi ◽  
Claudio Galante ◽  
Marco Domenicucci ◽  
Stefano Cattaneo ◽  
Andrea Achille Spreafico ◽  
...  

AbstractThe aim of the present study was to present clinical and radiological outcome of a hip fracture-dislocation of the femoral head treated with biomimetic osteochondral scaffold.An 18-year-old male was admitted to the hospital after a motorcycle-accident. He presented with an obturator hip dislocation with a type IVA femoral head fracture according to Brumback classification system. The patient underwent surgery 5 days after accident. The largest osteochondral fragment was reduced and stabilized with 2 screws, and the small fragments were removed. The residual osteochondral area was replaced by a biomimetic nanostructured osteochondral scaffold. At 1-year follow-up the patient did not complain of hip pain and could walk without limp. At 2-year follow-up he was able to run with no pain and he returned to practice sports. Repeated radiographs and magnetic resonance imaging studies of the hip showed no signs of osteoarthritis or evidence of avascular necrosis. A hyaline-like signal on the surface of the scaffold was observed with restoration of the articular surface and progressive decrease of the subchondral edema.The results of the present study showed that the biomimetic nanostructured osteochondral scaffold could be a promising and safe option for the treatment of traumatic osteochondral lesions of the femoral head.Study Design: Case report.


2014 ◽  
Vol 24 (4) ◽  
pp. 417-420 ◽  
Author(s):  
Matthew A. Lea ◽  
Bilal Barkatali ◽  
Martyn L. Porter ◽  
Timothy N. Board

1994 ◽  
Vol 61 (2) ◽  
pp. 151-153
Author(s):  
M. Marcellini ◽  
R. Cantiani ◽  
G. Mainiero ◽  
L Neri

The Authors report a case of vesical hemangioma; it was typical for site and clinical presentation whereas the age of onset and gross appearance were atypical. A TUR biopsy was performed without complications, but did not confirm diagnosis. A partial cystectomy was performed. A one-year follow-up, negative for recurrence, confirmed this procedure as the definitive treatment of choice.


2016 ◽  
Vol 136 (4) ◽  
pp. 229-232 ◽  
Author(s):  
Murat Kose ◽  
Oguz Kagan Bakkaloglu ◽  
Shirkhan Amikishiyev ◽  
Timur Selcuk Akpınar ◽  
Basak Saracoglu ◽  
...  

Acquired hemophilia is a relatively rare clinical presentation, and most cases present with acquired FVIII inhibitor. The co-occurrence of inhibitors to multiple coagulation factors is uncommon. These autoantibodies may induce spontaneous life-threatening bleeding in patients who have had no previous bleeding disorder. Herein, we present a patient with postpartum acquired FVIII and FIX inhibitors who developed intramuscular hematoma and hemothorax during follow-up. She was then treated with activated prothrombin complex concentrate and methylprednisolone.


2013 ◽  
pp. 46-47 ◽  
Author(s):  
Nathalia García-León ◽  
Gilberto E Marrugo

Mucoceles arising from the Blandin Nuhn glands are uncommon benign lesions of the oral cavity, which by their clinical presentation may be confused with more serious diseases such as vascular lesions, pyogenic granulomas, polyps, or squamous papillomas; thereby, it is convenient to be aware of the characteristics of this entity to guide the accurate and timely diagnosis and treatment. Herein, we present a case of a 10-year-old patient with a recurrent lesion of this type, which required surgical excision and marsupialization of the same, with no evidence of recurrence during follow-up.


2017 ◽  
Vol 31 (3) ◽  
pp. 335-338
Author(s):  
Pramod J. Giri ◽  
Vaibhav S. Chavan

Abstract Chondroblastoma of spine is very rare condition. To best of our knowledge, fewer than 30 cases have been reported in the world literature. Almost all of them involved both anterior & posterior component of vertebra. There are only few reports with isolated posterior element involvement. Clinical presentation of paraparesis because of vertebral chondroblastoma is very rare. This case report presents 17 yr old male with chondroblastoma involving posterior thoracic vertebra presenting with quadriparesis which improved after successful treatment. Early diagnosis and complete excision with periodic follow up is necessary for treatment of this disease.


2019 ◽  
Vol 109 (3) ◽  
pp. 231-234
Author(s):  
Eric So ◽  
Kevin Renner ◽  
Amanda Quisno ◽  
Daniel Logan

Tarsal coalitions typically occur at the talocalcaneal or calcaneonavicular joints. Common findings are pain, limited range of motion, and a pes planus deformity. The focus of this case report includes the presentation, imaging, treatment, and outcomes for a 21-year-old woman diagnosed with a rare lateral cuneocuboid coalition with chronic pain. Clinical and radiographic examinations, typically used to diagnose the common coalition, were unremarkable. Magnetic resonance imaging was diagnostic of the lateral cuneocuboid coalition, which was successfully treated with surgical resection. At 6-year follow-up, she reports resolution of symptoms and has returned to her normal presurgical activity level pain-free. This case is only the third lateral cuneocuboid coalition reported in the literature. The rarity of this coalition and its nonsuspicious clinical presentation make it worthy of acknowledgment.


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