Consultant Foot and Ankle Surgeon, Sir H N Reliance Foundation Hospital, Mumbai, MH, India.
Associate, Sir H N Reliance Foundation Hospital, Mumbai, MH, India.
J Foot Ankle Surg. 2021 May-Jun;60(3):630-633. doi: 10.1053/j.jfas.2020.08.034. Epub 2020 Oct 7.
Osteochondritis dissecans is a fairly recognized entity affecting the talus dome but subtalar joint involvement is not that common. We report a case of a 34-year-old male with osteochondritis dissecans of lateral process talus which was missed on imaging studies and identified intraoperatively. The patient was treated with curettage of the subchondral cyst at talus, followed by bone grafting and fixation of the osteochondral lesion with a 4-mm partially threaded cancellous screw. At the 1-year follow-up evaluation, there were no signs of recurrence and the patient resumed his complete activities including sports. We believe that the threshold for diagnosing these lesions should be low in cases with nonspecific chronic ankle pain, and surgeons are encouraged to consider this diagnosis.
剥脱性骨软骨炎是一种较为公认的疾病,影响距骨穹隆,但距下关节受累并不常见。我们报告了一例 34 岁男性患者,其距骨外侧突发生剥脱性骨软骨炎,影像学检查漏诊,术中发现。患者接受了距骨下软骨下囊肿刮除术,随后进行植骨和 4 毫米部分螺纹松质骨螺钉固定骨软骨病变。在 1 年的随访评估中,没有复发的迹象,患者恢复了包括运动在内的所有活动。我们认为,对于有非特异性慢性踝关节疼痛的病例,诊断这些病变的门槛应该较低,鼓励外科医生考虑这一诊断。