1. Osteochondral lesion of talar dome
Case for small group discussion
AOTrauma—Foot & Ankle
Module 16: Sports injuries
Per-Henrik Agren, SE

2. Case description
28-year-old woman, referred as osteochondral lesion (OCL) of talar dome
Injury on trampoline 4 years ago
MRI suggests lateral ligament disruption and medial talar dome lesion with osteophytes
Constant pain
Pain after jogging
Cannot wear heels
Varus

3. Preoperative x-ray

4. Preoperative x-ray

5. MRI scans

6. MRI scans

7. Procedure Medial approach
Chevron osteotomy of medial malleolus for visualization and access
Resect all osteophytes and deformity
Lateral heel shift of calcaneus for foot alignment

8. Postoperative x-ray

9. Postoperative x-ray

10. 4 months postoperative

11. 4 months postoperative

12. 4 months postoperative

13. 4 months postoperative

14. 4 months postoperative

15. Take-home messages
Although not a typical OCL but rather a shearing fracture of medial talus this illustrates:
Varus morphotype can aggravate or even produce lateral ankle instability and worsen symptoms of OCLs
High incidence of OCLs after ankle fractures and ligament ruptures
Treat associated deformities with OCLs