II. Definitions

  1. Osteochondritis Dissecans of Talus (Talar OCD)
    1. Traumatic defect in articular surface of talus
    2. Small area necrotic bone formation (Usually medial)

III. Epidemiology

  1. Adolescence or young adulthood

IV. Symptoms

  1. Persistent symptoms of "Ankle Sprain" that won't heal
  2. Gradual onset with distant history of ankle injury
  3. Painful limp
  4. Chronic swelling in ankle with activity

V. Signs

  1. Examine ankle with foot in plantar flexion
  2. Point tenderness over articular surface of talus
  3. Restricted Ankle Range of Motion

VI. Radiology

  1. Ankle XRay
    1. Necrotic fragment at joint
  2. Bone scan
  3. Ankle MRI

VII. Management

  1. Nondisplaced fragment
    1. No weight bearing until lesion heals
    2. Cast immobilization often needed
  2. Persistent symptoms or fragment detachment
    1. Surgical removal of necrotic fragment

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