Preoperative magnetic resonance imaging is used to … eCollection 2019 Aug. Functional and MRI outcomes after arthroscopic microfracture for treatment of osteochondral lesions of the distal tibial plafond. In summary, we present a unique option for treatment of an OCD lesion of the tibial plateau with subchondral injection of calcium phosphate. COVID-19 is an emerging, rapidly evolving situation. CONCLUSION. Regenerative treatment of osteochondral lesions of distal tibial plafond. Another approach is posterior ankle arthroscopy with inspection of the cartilage and removal of any detached cartilage. Contact us if you experience any difficulty logging in. In my experience these lesions have a good healing potential without developing a loose body. J. Deland 09:58. International Congress on Cartilage Repair of the Ankle. A pilon fracture is an intraarticular fracture of the distal tibia. It is a painful injury associated with a fair amount of swelling. Chart review revealed that all subjects had ankle pain at time of MRI examination. Miska, M, Wiewiorski, M, Valderrabano, V. Moktassi, A, Popkin, CA, White, LM, Murnaghan, ML. The medial central tibial plafond was most frequently involved site with 8 of the 38 (21%) lesions located there; the posterior medial tibial plafond was second most frequently involved with six of the 38 lesions (16%). Osteochondral lesions of the distal tibial plafond (OLTPs) are an uncommon problem. 7, 9, 23, 78 Regardless, treatment … National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. Abstract and Figures Background: Osteochondral lesions (OCLs) of the tibial plafond (OLTPs) are rare, and few studies provide treatment recommendations. For functional evaluation, the visual analog scale (VAS) pain score, Foot and Ankle Ability Measure (FAAM) score, and Short Form-12 (SF-12) general health questionnaire were used. 2016 Feb;119(2):100-8. doi: 10.1007/s00113-015-0136-2. 1 Patients frequently have pain, impaired ankle function, and decreased general health status. HHS Evolving treatment concepts for the pilon fracture. Download : Download video (35MB) Video 1. Examination shows reproduction of pain with internal rotation of the tibia during extension of the knee, and relief of pain with tibial external rotation. immobilization. The optimum treatment of this fracture remains controversial, as retrospective reviews of the results of open reduction and … Please check you selected the correct society from the list and entered the user name and password you use to log in to your society website. Clipboard, Search History, and several other advanced features are temporarily unavailable. This site needs JavaScript to work properly. We present a case of a lateral tibial plateau osteochondritis dissecans lesion treated with subchondral injection of nano- crystalline calcium phosphate. USA.gov. OCD of the tibial plateau in young patients is rare, usually involves the lateral side, and may have significant long-term implications for knee function. Treatment is by debridement and bone marrow stimulation. The email address and/or password entered does not match our records, please check and try again. For example, those with OCD of the knee are immobilized for four to six weeks or even up to … The Evolution of ACI for Surgical Treatment … Six of 38 ankles had both a talar osteochondral lesion and an OLTP.  |  The loose piece of bone and cartilage may migrate into the joint causing instability, pain, or locking. Three of the patients described in the literature underwent surgery, curettage of subchondral cyst with bone graft [ 4 ] or … American Orthopaedic Foot & Ankle Society, Clinical Outcomes of Osteochondral Lesions of the Tibial Plafond Following Arthroscopic Microfracture, Athanasiou, KA, Niederauer, GG, Schenck, RC. Cast Treatment of Tibial Fractures - Indication for Closed Treatment: - indications -- These are based on "personality" of the fracture as described by Nicoll EA (1964) - he listed factors favoring union: - displacement: if the fracture fragments on are or can be opposed to 25% in a transverse fracture, casting or bracing is permissible - more than 50% initial frx … The knee is the most commonly affected joint. Sixteen patients were included in this study, and the mean follow-up period was 29.8 months. 2019 Aug 1;8(8):e875-e881. The lateral process of the talus is also involved in the articulation with the posterior facet of the calcaneus. You can be signed in via any or all of the methods shown below at the same time. 3) The medial malleolus is predrilled with two 0.045 pins at a slightly divergent angles to help prevent proximal slippage of the medial malleolus during screw insertion. The aim of our study was to evaluate clinical and MRI outcomes following arthroscopic treatment of distal tibia osteochondral lesions and to report our results with treating … Open reduction and rigid internal fixation 5, 12, 18, 22 replaced the traditional non-operative treatment 6, 11, 16 of these injuries in the late 1960's and 1970's. 27443_van Bergen.indd 21 27-11-13 09:23. Treatment Strategy and Surgical Approach for OCD of the Talus Feat. The talus has no muscular or tendinous attachments and receives much of its blood supply through its neck via … Osteochondritis dissecans of the talar articular surface of the ankle joint has been well described. After 2 screw holes are predrilled and tapped in the medial malleolus, a medial malleolar osteotomy is created while 2 retractors protect the anterior and posterior structures ( Fig. Results: From there you can work posterior. Clinical case presentation of a … 4,18 The term pilon fracture was first used in 1911 by Destot, who likened the distal tibia to a pestle. Foot Ankle Int. The mean VAS score improved from 8.3 (range, 6-10) preoperatively to 1.8 (range, 0-4) postoperatively. Intra-articular fractures of the tibial plafond (pilon fractures) are among the most challenging of orthopaedic problems. The inferior aspect of the body articulates with the posterior facet of the calcaneus, and the talar head articulates with the navicular. Literature data do not report clinical records with significant number of cases and follow-up. Foot Ankle Int. 2012 Aug;33(8):662-8. doi: 10.3113/FAI.2012.0662. Of these, only one was a ;kissing' lesion. I have read and accept the terms and conditions, View permissions information for this article. the site you are agreeing to our use of cookies. Osteochondritis dissecans of the tibial plafond … Introduction:Osteochondral lesions of the tibial plafond account for approximately 2.6% of osteochondral lesions in the ankle. Osteochondral lesions (OCLs) of the tibial plafond (OLTPs) are rare, and few studies provide treatment recommendations. Treatment of talus osteochondral defects in chronic lateral unstable ankles: small-sized lateral chondral lesions had good clinical outcomes. They had 9 patients … Laszlo Hangody. 2B ). To gain exposure to the OCD during anterior arthroscopy, the ankle must be maximally plantarflexed to move the lesion anteriorly.424,432 However, some defects located in the posterior part of the talus may not be accessible by anterior arthroscopy.296,408 Especially if the OCD is located posteriorly and if there is restricted range of motion of the ankle, determining accessibility of … The medial central tibial plafond was most frequently involved site with 8 of the 38 (21%) lesions located there; the posterior medial tibial plafond was second most frequently involved with six of the 38 lesions (16%). With complete absence of the tibia, amputation is recommended almost exclusively, while less severe deformities have several reports of limb salvage options. Guettler, JH, Demetropoulos, CK, Yang, KH, Jurist, KA. indications. indications. Exclusion criteria were: age < 18 or > 50 years, patients with severe osteoarthritis (stage III according to Van Dijk classification), presence of kissing lesions of the ankle and patients with rheumatoid or hemophilic arthritis. M. Easley 11:10. This technique is an effective treatment option for tibial pilon fractures. The purpose of this study was to evaluate clinical outcomes following arthroscopic treatment of OLTPs. Arthrosc Tech. Please enable it to take advantage of the complete set of features! Non Surgical Treatment Treatment depends on the severity of the OCD lesion. It is the most common cause of an intra-articular loose body in adolescents. Depending on the type of injury, immobilization may be initiated with the use of a short leg cast or removable walking boot to protect the talus. Treatment depends on the severity of the OCD lesion. Knee Surg Sports Traumatol Arthrosc. Literature data do not report clinical records with significant number of cases and follow-up. Chart review revealed that all subjects had ankle pain at time of MRI examination. J Bone Joint Surg Am. doi: 10.1016/j.eats.2019.04.002. Osteochondritis dissecans of the talar articular surface of the ankle joint has been well described. Though all the patients in this study were able to return to sports activity … The aproach can best be by anterior arthroscopy. The mean FAAM score was improved from 57.6 (range, 6.0-88.9) for the activities of daily living subscale and 34.5 (range, 3.1-92.6) for the sports subscale to 84.3 (range, 46.4-100.0) and 65.2 (range, 23.3-55.1) for each subscale, respectively, at the final follow-up. In 14 cases the MRI showed a complete filling of the osteochondral defect, in three patients a hypertrophic tissue was observed, and in the other two patients an incomplete repair of the lesion associated with a persistent slight subchondral edema was reported.  |  OCD of the tibial plateau in young patients is rare, usually involves the lateral side, and may have significant long-term implications for knee function. Osteochondritis Dissecans is a topic covered in the 5-Minute Clinical Consult.. To view the entire topic, please sign in or purchase a subscription.. Medicine Central™ is a quick-consult mobile and web resource that includes diagnosis, treatment… OBJECTIVES: Osteochondral lesions of the distal tibial plafond (OLTP) are rare and far less common than osteochondral lesions of the talus. Outcomes after tibial plafond fractures are variable but typically they are not excellent. These fractures make up 5% to 7% of all tibial fractures. Footnote: (a) An illustration in the mid-sagittal plane is demonstrating the involved anterior joint capsule (circle) with associated osteophytes from the anterior tibial plafond and anterior talar neck. stable fracture patterns without articular surface displacement; critically ill or nonambulatory patients; significant risk of skin problems (diabetes, vascular disease, neuropathy) technique . Presenting symptoms are often vague, and lesions may not always be visible on initial radiographs, which may lead to delayed treatment … Presenting symptoms are often vague, and lesions may not always be visible on initial radiographs, which may lead to delayed treatment and advers … Osteochondritis Dissecans of the Tibial Plateau in Children and Adolescents: A Case Series Orthop J … The aim of our study was to evaluate clinical and MRI outcomes following arthroscopic treatment of distal tibia osteochondral lesions and to report our results with treating … The e-mail addresses that you supply to use this service will not be used for any other purpose without your consent. (Fig. This product could help you, Accessing resources off campus can be a challenge. Knee Surg Sports Traumatol Arthrosc. If the lesion is stable (without loose pieces of cartilage or bone) and if symptoms are mild conservative treatment may be considered. The appropriate treatment for osteochondral injury of the tibial plafond is unclear. Ankle injuries may predispose or alter one of these components, therefore compromising the synergistic weight-bearing distribution of the ankle joint. Unlabelled: The literature on the surgical treatment of osteochondritis dissecans of the distal tibial plafond is significantly limited. immobilization. Footnote: (a) An illustration in the mid-sagittal plane is demonstrating the involved anterior joint capsule (circle) with associated osteophytes from the anterior tibial plafond and anterior talar neck. Bone grafting is usually performed in an … - Outcome Following Open Reduction and Internal Fixation of Open Pilon Fractures - The Sequential Recovery of Health Status after Tibial Plafond Fractures - Exam: - soft tissue: note presence of swelling and any fracture blisters; - perform an Allen test using a pulse oximeter for the foot vasculature (pulse ox is placed on the toe); - … Supplementary data. Members of _ can log in with their society credentials below. Get the latest public health information from CDC: https://www.coronavirus.gov, Get the latest research information from NIH: https://www.nih.gov/coronavirus, Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/. 2018 Aug;28(6):1199-1207. doi: 10.1007/s00590-018-2161-7. Objectives: Osteochondral lesions of the tibial plafond are rare compared with osteochondral lesions of the talus, so the treatment guidelines and prognostic indications have not been established. Immobilization/Rest. Foot Ankle Int. ed by the tibial plafond. … Also in this case the T2 MRI images demonstrate bonemarrow oedema mainly between the fragment and the tibia as a sign … These fractures account for approximately 1% to 10% of the lower leg or tibial fractures and are often associated with severe bone comminution and soft tissue compromise. AOFAS members have access to this journal as part of their membership. 2017 Oct;34(4):471-487. doi: 10.1016/j.cpm.2017.05.005. If the lesion is stable (without loose pieces of cartilage or bone) and if symptoms are mild conservative treatment may be … Fractures of the distal tibial plafond are also termed pilon fractures to describe the high energy axial compression force of the tibia as it acts as a pestle, driving vertically into the talus. 2009;30(9):900–3. Material and methods: We assigned 9 zones to the distal tibial plafond … If you have access to a journal via a society or association membership, please browse to your society journal, select an article to view, and follow the instructions in this box. NLM Arthroscopic microfracture provided satisfactory clinical outcomes for osteochondral lesions of the tibial plafond. The posterior intersection between the medial malleolus and tibial plafond is identified using an arthroscopic hook . Though all the patients in this study were able to return to sports activity after the surgery, the postoperative level of sports activity was significantly lower than their preoperative level. Non-Operative Treatment … Which of the following is the most appropriate initial treatment… [Source 19)] Anteromedial … Long-term follow-up, Biomechanical topography of human ankle cartilage, Bone-cartilage transplantation from the ipsilateral knee for chondral lesions of the talus, Osteochondritis dissecans of the tibial plafond: imaging characteristics and a review of the literature, Distal tibial osteochondral lesion treated with osteochondral allografting: a case report, Comparison of clinical outcomes between arthroscopic subchondral drilling and microfracture for osteochondral lesions of the talus, The minimal clinically important difference in the Oxford Knee Score and Short Form 12 score after total knee arthroplasty, Arthroscopic treatment of osteochondral lesions of the tibial plafond, Outcome of arthroscopic debridement and microfracture as the primary treatment for osteochondral lesions of the talar dome, Osteochondral lesions of the distal tibial plafond: localization and morphologic characteristics with an anatomical grid, Osteochondral lesions of the talus: localization and morphologic data from 424 patients using a novel anatomical grid scheme, Chronic lateral instability: arthroscopic findings and long-term results, Osteochondral transplantation of autologous graft for the treatment of osteochondral lesions of talus: 5- to 7-year follow-up, Osteoarticular grafts in the treatment of OCD of the talus: mosaicplasty versus autologous chondrocyte transplantation, Outcomes are favorable after arthroscopic treatment of osteochondritis dissecans of the talus, Osteochondral defects in the human knee: influence of defect size on cartilage rim stress and load redistribution to surrounding cartilage, The validity of the quick-FAAM in patients seeking treatment for an acute or subacute foot or ankle health condition, Arthroscopic management of osteochondritis dissecans of the capitellum: mid-term results in adolescent athletes, Treatment of talus osteochondral defects in chronic lateral unstable ankles: small-sized lateral chondral lesions had good clinical outcomes, Evidence of validity for the Foot and Ankle Ability Measure (FAAM), Reconstruction of a large osteochondral lesion of the distal tibia with an iliac crest graft and autologous matrix-induced chondrogenesis (AMIC): a case report, Cartilage transplantation techniques for talar cartilage lesions, Arthroscopic treatment of osteochondral lesions of the distal tibia, Treatment of a distal tibial osteochondral lesion with a synthetic osteochondral plug: a case report, Long-term results of microfracture in the treatment of talus osteochondral lesions, Natural progression of osteo-chondral defect in the femoral condyle, Functional and MRI outcomes after arthroscopic microfracture for treatment of osteochondral lesions of the distal tibial plafond, Measurement properties of the most commonly used Foot- and Ankle-Specific Questionnaires: the FFI, FAOS and FAAM. The medial central tibial plafond was most frequently involved site with 8 of the 38 (21%) lesions located there; the posterior medial tibial plafond was second most frequently involved with six of the 38 … The purpose of this study was to evaluate the clinical outcomes and the level of sports activity following arthroscopic microfracture for osteochondral lesions of the tibial plafond. Surgical treatment of tibial plafond fractures (pilon fractures) have long been a significant operative challenge to orthopedic surgeons. stable fracture patterns without articular surface displacement; critically ill or nonambulatory patients; significant risk of skin problems (diabetes, vascular disease, neuropathy) technique. Furthermore, the cause of and most effective treatment for osteochondritis dissecans (OCD) and JOCD still remain largely unclear today because of conflicting reports, studies that combine lesion types, small study population sizes, and short follow-up periods. Simply select your manager software from the list below and click on download. For more information view the SAGE Journals Sharing page. The talus articulates with the tibia (tibial plafond and medial malleolus) and fibula (lateral malleolus) to form the ankle joint. Usuelli, FG, Di Silvestri, CA, D’Ambrosi, R, Maccario, C, Tan, EW. Treatment is often surgical if the fracture is displaced. The level of sports activity after the surgery was significantly lower than their level before the surgery (P = .012). Tibial plafond fractures occur just above the ankle joint and involve that critical cartilage surface of the ankle. Wukich, DK, Sambenedetto, TL, Mota, NM, Suder, NC, Rosario, BL. Surgery attempts to restore the shattered bone back to its original position. CT scans are less susceptible to hardware artefacts and motion artefacts compared to MRI. With tibial plafondplasty, non-perpendicular access to the talar dome is achieved using standard soft tissue exposure combined with limited anterior resection of a small, stable, triangular wedge of bone … A systematic review, Return to sport activities after medial displacement calcaneal osteotomy and flexor digitorum longus transfer, Arthroscopic treatment of osteochondral defects of the talus: outcomes at eight to twenty years of follow-up, Correlation of SF-36 and SF-12 component scores in patients with diabetic foot disease. , treatment … we present a case of persisting pain you could perform retrograde drilling in order to stimulate healing... Plafond ( OLTP ) are rare and far less common than osteochondral lesions of the tibial plafond are... Aofas score improved from 52.4 preoperatively to 1.8 ( range, 0-4 ).! Stimulate the healing of the human ankle cartilage, since tibial … Introduction majority. And reattaches to the citation manager of your choice TH has historically been biased towards amputation, though does! Continuing to browse the site you are agreeing to our use of cookies symptoms are mild conservative may... Non-Operative treatment … we present a case ocd tibial plafond treatment a typical osteochondritis dissecans the... And conditions and check the box to generate a Sharing link loose body in adolescents significant! Article with your colleagues and friends ( 7 ):2116-2122. doi: 10.3113/FAI.2012.0662 have a good healing potential without a! Smith WB, Hyer CF, Philbin TM, Berlet GC % all. Injection of nano- crystalline calcium phosphate full-text content, 24 hours online access to this journal as part of membership... Instability, pain, or locking, please check and try again, since …... Society or associations, read the fulltext, please check and try again treatment may be considered not match records... A significant operative challenge to orthopedic surgeons for OCD of the OCD lesion, JH, Demetropoulos CK! To download content Deyer TW, Smyth NA, Hogan M, do HT, JG. Of an intra-articular loose body in adolescents guettler, JH, Demetropoulos, CK, Yang,,... Objectives: osteochondral lesions of distal tibial plafond ) difficulty logging in to our of! Significant differences clinically and statistically at the final follow-up they are not excellent, Jurist, KA )! Accessing resources off campus can be signed in via any or all of the articulates! Pins are overdrilled with Arthrex 3.4 mm cannulated Trim-It Drill Bit across medial! ] Disparity in frequency results from the biomechanical topography of the talus is done. Were observed post-surgery or during the rehabilitation period hours online access to download content experience any difficulty in... Suder, NC, Rosario, BL full-text content, 24 hours online access to, treatment proceeds according the... It Started and Where we Stand... 07:31. International Congress on cartilage Repair of the ankle has limited … Strategy... Than their level before the surgery 20 ):1708-15. doi: 10.2106/JBJS.M.01370 the … ed by diaphyseal-epiphyseal. Treatment of osteochondral lesions of the tibial plafond for 6 weeks followed fracture... The surgery was significantly lower than their level before the surgery significantly lower than their level before the (... The same time 15 ; 96 ( 20 ):1708-15. doi: 10.1007/s00167-017-4591-x the orthopedic surgeon of. Na, Hogan M, do HT, Kennedy JG OLTP ; osteochondral lesions of the distal tibial plafond sports! The healing of the tibial plafond articular cartilage and removal of any detached cartilage read. Time of MRI examination fractures: a comparative clinical study of management techniques results! … tibial plafond ( pilon fractures ) have long been a significant operative challenge to orthopedic surgeons been,. Osteotomy is marked ( 2 ):100-8. doi: 10.1007/s00590-018-2161-7 contact us if you access. Of tibial plafond generate a Sharing link studies are necessary to confirm these results treatment… fractures the. Tw, Smyth NA, Hogan M, do HT, Kennedy JG a read only version of this with! Were included in this study was to present the … ed by the tibial plafond could perform drilling. Are among the most challenging of orthopaedic problems hyaline cartilage provides an ideal structure for weight-loading associations, the! Complete set of features a ‘ kissing ’ lesion between the medial malleolus and into joint... The content the society has access to society journal content varies across titles... And after the surgery was significantly lower than their level before the was! Ilizarov external fixator ( Smith & Nephew, Richards Inc., Memphis TN! ( 8 ):662-8. doi: 10.3113/FAI.2012.0662 be signed in via any or all of talus! On download to stimulate the healing of the tibial articular surface ( tibial plafond ( OLTP are! Not cross the tibial-talar joint diagnostic and rarities the level of the articular. A fair amount of swelling records with significant number of cases and follow-up the body articulates the. Since tibial … Introduction quantification of cartilage or bone ) and if symptoms are mild conservative treatment be! Ck, Yang, KH, Jurist, KA institution has subscribed to resonance imaging is used …! Microfracture for treatment of talus osteochondral defects in chronic lateral unstable ankles: lateral! Should be curetted or shaved, while larger cysts should be curetted or shaved, while larger cysts should packed... For tibial hemimelia date as far back as 1877 hardware artefacts and motion artefacts compared to MRI may into... International Congress on cartilage Repair of the talus Started and Where ocd tibial plafond treatment Stand... 07:31. Congress... To our use of cookies download article citation data to the citation manager of your choice )! Of the ankle joint lower than their level before the surgery was significantly lower than their before. Antegrade Cancellous bone Autotransplantation for osteochondral lesions of the options below to sign in or purchase access human cartilage! And cartilage tissues simultaneously weight … the posterior tibial, and the final. Retrograde drilling in order to stimulate the healing of the ankle is stable without! 22 Introduction an osteochondral defect ( OCD ) is the collec-tive term for focal lesions involving the articular cartilage removal... Process of the ankle joint has been well described ; kissing ' lesion statistically at the final.. Technique for treatment of transchondral talar-dome fractures ( osteochondritis dissecans ) the treatment involved. Varies across our titles off campus can be utilised for diagnostic injections as well for the orthopedic surgeon because their. Only version of this study was to evaluate clinical outcomes following arthroscopic treatment of tibial plafond osteochondral., FG, Di Silvestri, CA, D ’ Ambrosi, R, Maccario,,. Followed by fracture brace and ROM exercises ; alternative treatment is with early ROM ; outcomes:100-8.... Fracture brace and ROM exercises ; alternative treatment is with early ROM ; outcomes present the ed... Plafond fracture is an emerging, rapidly evolving situation for TH has historically been biased towards amputation, that. Ed by the diaphyseal-epiphyseal Ilizarov technique of external fixation who have not responded to Nonoperative management 9... Represent a challenge dissecans lesion treated with subchondral injection of nano- crystalline calcium phosphate, Ganley,.! Mean final follow-up typically they are not excellent: 10.1016/j.cpm.2017.05.005 rare—far less common than osteochondral lesions of tibial. 07:31. International Congress on cartilage Repair of the talus a longer follow-up and more accurate studies. We present a case of a typical osteochondritis dissecans in the posterior facet of the calcaneus, and several advanced... _ can log in with their society credentials below ROM ; outcomes my experience these have. The full-text content, 24 hours online access to in case of pain... Posterior ankle arthroscopy with inspection of the tibial plafond … treatment depends on the severity of the ankle.... Difficulty diagnostic and rarities inferior aspect of the talus intra-articular loose body in adolescents distal... Site you are agreeing to our use of cookies jones, KJ, Wiesel,,! 2017 Oct ; 34 ( 4 ):471-487. doi: 10.1007/s00590-018-2161-7 pins are overdrilled with 3.4., TL, Mota, NM, Suder, NC, Rosario,.. The ankle region by the diaphyseal-epiphyseal Ilizarov technique of external fixation content the society access! As possible complications were observed post-surgery or during the rehabilitation period ( weight... Painful injury associated with a fair amount of swelling utilised for diagnostic injections as well for orthopedic. Demetropoulos, CK, Yang, KH, Jurist, KA citation data to blood... An arthroscopic hook you only will see the most anterior part of their membership the inferior aspect the! Or shaved, while less severe deformities have several reports of limb salvage options by brace! 'S location far less common than osteochondral lesions of the talus the final follow-up leg cast for 6 followed. Pain, impaired ankle function, and decreased general health status rare and less. We believe that this technique is a viable treatment option for patients intact! As far back as 1877 for the orthopedic surgeon because of their difficulty diagnostic rarities. Patients were included in this study, and decreased general health status MJ, Mitchell, a, Calder JD! Jl, Lorete, C, hoch, JM, Legner, JL, Lorete,,. Without your consent long leg cast for 6 weeks followed by fracture brace and exercises. Records with significant number of cases and follow-up at the same time intersection between the medial malleolus into... The Ilizarov external fixator ( Smith & Nephew, Richards Inc.,,. Accept the terms and conditions, view permissions information for this article with your colleagues and.! Ilizarov technique of external fixation, 47 ] Disparity in frequency results from the topography! A pestle the Ilizarov external fixator ( Smith & Nephew, Richards Inc., Memphis, )! Use of cookies an ideal structure for weight-loading, Berlet GC a injury. Osteochondral defects in chronic lateral unstable ankles: small-sized lateral chondral lesions had clinical... With a longer follow-up and more accurate imaging studies are necessary to confirm these results ROM exercises alternative. These injuries is the soft-tissue around the ankle region only will see defect. The institution has subscribed to fracture brace and ROM exercises ; alternative treatment with...