Osteochondritis Dissecans of Talus


Osteochondritis Dissecans of Talus, Talar OCD, Talar Avascular Necrosis

  • Definitions
  1. Osteochondritis Dissecans of Talus (Talar OCD)
    1. Traumatic defect in articular surface of talus
    2. Small area necrotic bone formation (Usually medial)
  • Epidemiology
  1. Adolescence or young adulthood
  • 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
  • Signs
  1. Examine ankle with foot in plantar flexion
  2. Point tenderness over articular surface of talus
  3. Restricted Ankle Range of Motion
  • Radiology
  1. Ankle XRay
    1. Necrotic fragment at joint
  2. Bone scan
  3. Ankle MRI
  • 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