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View Full Version : osteochondral injury involving the dome of the talus with trace joint effusion



zak
24-04-2004, 01:49 AM
Hi, I am a soocer player. I injured my left ankle during a game about 6 months ago, since then the pain doesn t want to go away and even though i am able to jog with little pain i still don't feel confortable enough to go back to soccer.
I had 2 CT scans done on my ankle and here what they say:

Exam date 11/10/2003
FINDINGS: There is a joint effusion present. An avulsion fracture of the posteromedial aspect of the dome of the talus is noted. There is a well corticated calcification extending along the antiror aspect of the distal fibula which likely represents an old avulsion fracture. Similar finding is seen at the level of the dorsal aspect of the avicula. No other acute fractures or dislocations are identified. Visualized joint spaces are otherwise unremarkable.

IMPRESSION: 1. Small posteromedial avulsion fracture off the dome of the talus with joint effusion as above. 2. Likely old avulsion fracture distal fibula and navicula.


Exam Date 04/21/04
FINDINGS: Comparison is made to the prior study dated 11/10/03. There is a minimal joint effusion present. the previously noted osteochondral injury involving the postromedial aspect of the talar dome which is essentially stable since the prior examination. There is a stable curvilinear segment of cortex which appears stable since the the prior exam. The old avulsion fracture in the anterior aspect of the fibula/malleolus is stable as well. There is a stable prominent osteophyte arising from the dorsum of the foot at the level of the talonavicular joint along the dorsum of the foot with central linear lucency. An old fracture of this osteophyte is possible.

IMPRESSION: Stable examination. Osteochondral injury involvong the dome of the talus with trace joint effusion. No interval change. Old injuries involving the fibula and navicula are also stable.

As you would expect this is like chinese to me. if you could help me understand it and give me your impressions and predictions on me coming back to soccer, i'll be forever gratefull. Thanks in advance. sincerly, Zak.

injuryupdate
24-04-2004, 07:59 AM
These scans aren't great news, because it sounds as though your major injury is the osteochondral fracture of the talus. This is a semi-degenerative injury to the lining cartilage of the ankle joint. It is definitely possible that surgery (ankle arthroscope) might help fix your pain, although it probably will take a while to resolve and there is a chance your ankle might never be 100%.

Worth taking the scans back to your doctor, and if he/she isn't a foot and ankle surgeon, ask for a referral on to one.

u1990
12-07-2004, 09:44 PM
My reply is to Zak, the soccer player with the talar dome injury. I play Aussie Rules Football, and have the same injury by the sounds of it.

I had an arthroscope on the joint in November 2002 after suffering pain in that area all season after landing awkwardly in a pre-season game, and it still hurts now. After the surgery I rested the ankle pretty much all summer till about Feb-Mar 2003, having been told to avoid running/jumping etc on hard surfaces (forever).

The surgeon had to remove a layer of the cartilage and there were loose bits of bone/cartilage and whatever else floating around in the joint. He scraped out all that, and unfortunately the layer of cartilage came too.

Apparently, when you do a twisting ankle injury, you can easily shear off a piece of the talus which floats around and eventually plays up, like it did for me. The surgeon said that my injury was probably up to five years old before I noticed the pain.

Heat is the only thing that helps now, and I have found that strengthening the muscles around the joint seems to help too. I am going to see a foot/ankle specialist in Melb (W Edwards) soon for further opinion as to what else I can do, (eg. cartilage replacement when technology becomes available, other rehabilitation).

My advice is to explore all options with your surgeon as to what else you can do to rehabilitate the joint, as I do not think mine will ever be back to normal now.

I am also taking Glucosamine supplements, apparently helpful in cartilage regeneration.

Does anyone else have any experience in these injuries and what you can do if you've lost the cartilage?