Schachter Aaron K, Chen Andrew L, Reddy Ponnavolu D, Tejwani Nirmal C
Department of Orthopaedic Surgery, NYU-Hospital for Joint Diseases, New York, NY, USA.
J Am Acad Orthop Surg. 2005 May-Jun;13(3):152-8. doi: 10.5435/00124635-200505000-00002.
Osteochondral lesions of the talus occur infrequently and usually represent late sequelae of ankle trauma. Because of the functional significance of the talus and its limited capacity for repair, correct early diagnosis is important. Osteochondral fractures should be suspected in patients with chronic ankle pain, especially those with a prior ankle injury. Historically, plain radiographs have been used to stage lesions; more recently, magnetic resonance imaging and arthroscopy have been used. Non-surgical management remains the mainstay of treatment of acute, nondisplaced osteochondral lesions. Surgical management is reserved for unstable fragments or failure of nonsurgical treatment. Recent advances in osteochondral grafting have allowed reconstruction of the talar dome, leading to more predictable relief of pain and improvement of function.
距骨骨软骨损伤并不常见，通常是踝关节创伤的晚期后遗症。由于距骨的功能重要性及其有限的修复能力，早期正确诊断很重要。对于慢性踝关节疼痛患者，尤其是有踝关节既往损伤史的患者，应怀疑有骨软骨骨折。过去，X线平片一直用于对损伤进行分期；最近，磁共振成像和关节镜检查也已被应用。非手术治疗仍然是急性、无移位骨软骨损伤治疗的主要方法。手术治疗适用于不稳定碎片或非手术治疗失败的情况。骨软骨移植的最新进展使得距骨穹窿得以重建，从而更可预测地缓解疼痛并改善功能。
