osteochondritis dissecans tali a review and case presentation seregelyi t. dr. solyom a. dr....
TRANSCRIPT
Osteochondritis Dissecans TaliA Review and Case Presentation
Seregelyi T.Dr. Solyom A.Dr. Ivanescu A.Prof. Dr. Bataga T.
Osteochondritis Dissecans Tali
“os-tee-o-kon-DRY-tis DIS-uh-kanz”
Osteo = Bone,Chondros = Cartilage, Dissecare = to Dissect, reject
What is Osteochondritis Dissecans ?
“Dissecating Osteochondral Lesion Of The Talus” (Assenmacher et al)
or
“Transchondral Talar Dome Fracture” (Kocher et
al) ?
Etiology ?
External
• Antero-Lateral Talar Dome Lesion
• History of Trauma (sprain or strain)
• Wafer-shaped
• More Aggressive (/surgical) Treatment recommended
Internal
• Medial Talar Dome
• Associated with Chronic Overload (eg. cavus foot)
• Cup-shaped
• More Frequent• Often Asymptomatic
Signs & Symptoms
-> Unspecific
Gradual onset of Chr. Activity-Related PainIntermittent EdemaDecreased ROMJoint lockingInstabilityPopping soundsLimping
Diagnosis
Anamnesis Xray CT (sections) Scintigraphy (for screening) MRI (gold standard, classification) +/- Arthroscopy (in discussion now)
Classification
Ferkel Loomer CT
Berndt & Harty
Berndt & Harty
stage 1 Stage 2
Berndt & Harty
Stage 3 Stage 4
Case Presentation
Tx: Mosaicplasty
ipsilateral mosaicplasty-type autologous osteochondral grafting
Intra-operative fluoroscopic view showing the two 4.5mm cannulated screw fixation of medial malleolus after graft implantation
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