Acta clinica Croatica, Vol. 57. No. 2., 2018.
Other
https://doi.org/10.20471/acc.2018.57.02.21
Lateral Inverted Osteochondral Fracture of the Talus: Case Reports and Review of the Literature
Andrija Jurina
; Department of Surgery, Division of General and Sports Traumatology and Orthopedic Surgery, Merkur University Hospital, Zagreb, Croatia
Valentina Delimar
; Krapinske Toplice Special Hospital for Medical Rehabilitation, Krapinske Toplice, Croatia
Damjan Dimnjaković
; Department of Orthopedic Surgery, Zagreb University Hospital Centre, Zagreb, Croatia;
Ivan Bojanić
; Department of Orthopedic Surgery, Zagreb University Hospital Centre, Zagreb, Croatia; University of Zagreb, School of Medicine, Zagreb, Croatia
Abstract
Lateral inverted osteochondral fracture of the talus (LIFT) is a rare variant of stage IV osteochondral lesion of the talus (OLT), where the fragment is inverted in situ by 180°. The management of LIFT lesion is very challenging and early recognition crucial, given that treatment options depend on the articular cartilage condition and sufficiency of the adjacent bone of the displaced fragment. We describe two LIFT cases referred from other institutions after unsuccessful conservative treatment of OLT. They presented with pain, swelling and tenderness over the anterolateral aspect of the right ankle. We recognized the LIFT lesion on the magnetic resonance imaging scans in patient 2, while in patient 1 the orientation of the fragment was recognized upon direct visualization during operative treatment. Both patients underwent arthroscopic procedure. Due to articular cartilage damage and insufficiency of the adjacent bone of the fragment, both patients were treated with excision followed by microfracture. Treatment of the LIFT lesion should start arthroscopically to allow clear evaluation of the osteochondral fragment, assessment of the talar defect and identification, as well as treatment of associated disorders. If the articular cartilage appears intact with sufficient subchondral bone, fixation of the fragment is optimal management, otherwise excision and microfracture can be the treatment of choice.
Keywords
Talus - injuries; Cartilage, Articular; Cartilage Diseases; Conservative Treatment; Magnetic Resonance Imaging; Arthroscopy
Hrčak ID:
207567
URI
Publication date:
1.6.2018.
Visits: 2.505 *