[Osteochondral lesions of the talus].

Osteochondral lesions occur either as osteochondral fractures (so called flake fractures) or osteochondritis dissecans. Both types of lesions are caused in the most of the cases by an adequate trauma. The injury is sustained during inversion of the ankle. If the foot is dorsiflexed, an anterolateral lesion will result from shearing forces by the fibula. If the inversed foot is plantar flexed and followed by rotation of the tibia on the talus, a postero-medial lesion will result from compression of the medial talar dome by the tibia, secondary to spiralling and shortening of the collateral ligaments. The diagnosis is suspected with the most common complaints of the patients to pain on weight bearing or during sports, swelling, crepitus, giving way or locking ankle after an inversion injury. In case of negative standard X-rays and doubtful clinical findings tomograms in the AP and lateral views or even a scintigraphy of both ankles ar indicated. 15 patients with osteochondral lesions were treated, 7 with an antero-lateral transchondral fracture and 8 with a poster-medial osteochondritis dissecans. The lesions were classified after Berndt and Harty and differentiated between type I-IV. 13 patients have been operated, 4 by arthroscopy. The mean follow-up time of the clinical and radiographic examination was 1 year. The results were evaluated by a point score system. 7 patients (46.6%) had good, 5 (33.3%) a fair and 3 (20%) a poor result.(ABSTRACT TRUNCATED AT 250 WORDS)