• Title/Summary/Keyword: talus

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Clinical Evaluation of the Fracture of Talar Neck (거골 경부 골절에 대한 치료)

  • Rhee, Jin-Hong;Lee, Jeong-Woung;Cho, Jae-Young;Bae, Sang-Won;Lee, Eui-Hyung;Lee, Ju-Youn
    • Journal of Korean Foot and Ankle Society
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    • v.1 no.2
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    • pp.119-125
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    • 1997
  • The fracture and fracture-dislocation of the neck of the talus (Hawkins' type I-IV) are uncommon injuries and represent only 0.12 to 0.32% of all fracures. Authors clinically evaluated in 12 cases Whom treated fracures of the neck of the talus, at department of orthopaedic surgery, Sun General Hospital, from 1990 to 1996, and the following results are obtained. 1. Of 12 cases, there were 11 males and 1 female, average age was 30 years. 2. Causes of fracture was fall down injury in 7 cases(58%), traffic accident in 4 cases(33%), direct trauma in 1 case(8%). 3. According to the classification by Hawkins' type I in 2 cases(17%), type II in 7cases (58%), type III in 3cases(25%). 4. Associated injuries were calcaneal fracture in 3 cases, fracture-dislocation of talus in 3 cases, subtalar dislocation in 3 cases, medial malleolar fracture in 5 cases, soft tissue injury in 3 cases, femur and tibia fracture in 1 case, and lumbar Spine compression fracture in 1 case. 5. Average time to operation after injury was 2.5 days. 6. In 2 cases were treated conservatively and 10 cases were treated open reduction and internal fixation with screw or K-wire. 7. Complications were avascular necrosis in 4 cases, post traumatic arthritis in 2 cases, skin necrosis in 4 cases, and then ankle fusion was done in 2 cases. 8. High rate of complication was seen in the talar neck fracture associated with calcaneal fracture. In the analysis of above results, evaluated by Hawkins' scoring system were excellent to fair in 75%.

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Osteosarcoma of the Talus - Case Report - (거골에 발생한 골육종 - 증례 보고 -)

  • Kim, Byoung-Suck;Lim, Ho-Yeung;Cho, Jae-Hyun;Kim, Tae-Hong;Lee, Kyi-Beom
    • The Journal of the Korean bone and joint tumor society
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    • v.8 no.3
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    • pp.90-95
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    • 2002
  • A 42 year old male patient complained of increasing pain and mass around the right ankle with 4 months duration. Simple Roentgenogram and CT showed ill-defined osteolysis and cortical perforation in the neck of the right talus. The pathologic findings showed high grade osteoblastic osteosarcoma. The tumor mass of the ankle increased and pulmonary metastasis was found in spite of administrating of two cycles of preoperative chemotherapy. Below-knee amputation and open wedge pulmonary resection were performed for primary lesion and multiple pulmoanry metastasis, respectively. However, the patient died with multiple pulmonary metastasis in spite of three cycles of postoperative chemotherapy at ten months after the operation.

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Intermediate-Term Clinical Outcomes after Autologous Osteochondral Transplantation for Lateral Osteochondral Lesions of the Talus (외측 거골 골연골 병변에 대한 자가 골연골 이식술 후의 중기 추시 임상결과)

  • Sung-Hoo Kim;Byung-Ki Cho
    • Journal of Korean Foot and Ankle Society
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    • v.27 no.4
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    • pp.137-143
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    • 2023
  • Purpose: Autologous osteochondral transplantation (AOT) is indicated for patients with a large osteochondral lesion of the talus (OLT), accompanying subchondral cyst, and the failure of bone marrow stimulation (BMS) procedures. Despite the many reports on the clinical results of surgical treatment for medial osteochondral lesions, those of lateral lesions are rare. This paper reports the intermediate-term clinical outcomes after AOT for lateral OLTs. Materials and Methods: Twenty-one patients with lateral OLTs were followed up for at least three years after AOT. The clinical evaluations comprised the Foot and Ankle Outcome Score (FAOS) and Foot and Ankle Ability Measure (FAAM). The radiographic assessment included the irregularity of the articular surface (subchondral plate), the progression of degenerative arthritis, and the changes in talar tilt angle and anterior talar translation. Results: The mean FAOS and FAAM scores improved significantly from 42.1 to 89.5 and 39.5 to 90.6 points, respectively, at the final follow-up (p<0.001). The radiological evaluation revealed two cases (9.5%) of articular step-off ≥2 mm and 1 case (4.8%) of progressive arthritis. The mean talar tilt angle and anterior talar translation improved significantly. As postoperative complications, there was one case of a local wound problem, one case of superficial peroneal nerve injury, and one case of donor site morbidity. At a mean follow-up of 62.3 months, no patient showed a recurrence of instability or required reoperation for OLT. Conclusion: AOT for the lateral OLTs demonstrated satisfactory intermediate-term clinical outcomes, including daily and sports activity abilities. Most OLT could be accessed through lateral ligament division and capsulotomy, and the incidence of iatrogenic complications, such as recurrent sprains or chronic instability, was minimal. AOT appears to be an effective and relatively safe treatment for patients with large lateral osteochondral lesions unresponsive to conservative therapy, with subchondral cysts, or with failed primary BMS.

Bony Union of Osteochondral Lesion of the Talus after Bone Marrow Aspirate Concentrate and Matrix-Induced Chondrogenesis: A Case Report (골수흡인물 농축액 및 기질유래연골형성 수술 이후 관찰된 거골의 골연골병변의 골유합: 증례 보고)

  • Tae Hun Song;Jin Soo Suh;Jun Young Choi
    • Journal of Korean Foot and Ankle Society
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    • v.27 no.4
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    • pp.148-153
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    • 2023
  • Traditionally, arthroscopic microfracture and autologous osteochondral autograft transplantation have been the primary surgical treatments for osteochondral lesions of the talus. On the other hand, recent advancements have introduced alternative approaches, such as autologous chondrocyte transplantation, matrix-derived autologous chondrocyte transplantation, intra-articular injection of concentrated bone marrow aspirate concentrate, and the use of fibrin glue to address chondral defects. Furthermore, some studies have explored a combination of bone marrow aspirate and matrix-derived chondrogenesis. In light of these developments, this report presents a case study of a young male patient in his early twenties with a relatively large osteochondral lesion exceeding 1.5 cm2 on the medial talar dome. Instead of removing the osteochondral lesion, a surgical approach was employed to retain the lesion while addressing the unstable cartilage in the affected area. This approach involved a combination of bone marrow aspirate concentrate and matrix-derived chondrogenesis. The treatment yielded favorable clinical outcomes and ultimately successfully induced the bony union of osteochondral lesions. This paper reports the author's experience with this innovative approach with a review of the relevant literature.

Effects of Tibiofibular Joint Mobilization on Range of Motion, Balance, and Pain in Patients with Lateral Ankle Sprain (정강종아리 관절가동술이 외측 발목염좌 환자의 통증, 관절가동범위 및 균형에 미치는 영향)

  • Eui-young Jeong;Si-hyun Park
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.30 no.1
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    • pp.51-60
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    • 2024
  • Background: Ankle sprains are a common clinical ankle disorder and alternations in tibiofibular joint biomechanics along with the talus are thought to contribute to its occurrence. During ankle joint dorsi flexion, proper movement requires the talus to glide posteriorly. Due to the wider front of the talus head, achieving the end range of dorsi flexion necessitates both superior and posterior glide of the distal fibula and anterior glide of the proximal fibula. The purpose of this study was to investigate the effects of tibiofibular joint mobilization on pain, range of motion, and balance in patients with lateral ankle sprains. Methods: Participants were randomly assigned to a control group (n=33) or an experimental group (n=31). Both groups underwent ankle joint mobilization three times a week for two weeks. Additionally, the experimental group received proximal and distal tibiofibular joint mobilization three times a week for two weeks. Measurements were obtained pre-intervention and post-intervention (after 2 weeks). Results: Evaluation parameters included the visual analog scale score (VAS), range of motion (ROM), and one-leg standing test (OLS). Post-intervention, both groups demonstrated significantly improved results for all assessments (p<.01). A significant intergroup difference was observed only in the ROM (p<.01) and OLS (p<.05). Conclusion: Our findings suggest that tibiofibular joint mobilization, combined with ankle joint mobilization, may be beneficial in enhancing outcomes for individuals with lateral ankle sprains.

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A Study on the Vegetation Structure of Algific Talus in Korea (한반도 풍혈지의 식생구조에 관한 연구)

  • Kim, Jin-Seok;Yun, Jong-Hak
    • Korean Journal of Environment and Ecology
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    • v.27 no.3
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    • pp.357-368
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    • 2013
  • This study was carried out to classify and describe the vegetation of algific talus in Korea by methods of the ZM school of Phytosociology. A part of slope or a hollow at the foot of talus in which cool air exhausts from underground through gaps of accumulated rock debris is called algific talus. From the sixty three stands obtained, the following two community and their four subcommunity were recognized: A. Quercus variabilis - Cystopteris fragilis com. B. Quercus mongolica - Betula schmidtii com. B-1. Quercus serrata - Urtica angustifolia subcom. B-2. Sorbus commixta - Spiraea chamaedryfolia subcom. B-3. Zabelia biflora - Astilboides tabularis subcom. B-4. Typical subcom. A. Quercus variabilis - Cystopteris fragilis com.. As a result of DCCA ordination, Quercus variabilis - Cystopteris fragilis com. has Quercus variabilis, Ligustrum var. obtusifolium, Zelkova serrata, Viburnum carlesii etc. as differential species, which showed the higher correlation with area of high Warmth index (WI) and precipitation than Quercus mongolica - Betula schmidtii com. has Quercus mongolica, Sorbaria var. sorbifolia, Magnolia sieboldii, Acer pseudosieboldianum, Rosa acicularis etc. as differential species. Sorbus commixta - Spiraea chamaedryfolia subcom. has Spiraea chamaedryfolia, Sorbus commixta, Rosa koreana, Vaccinium var. hirtum, Acer tegmentosum, Dryopteris expansa, Abies holophylla etc. as differential species. and Typical subcom in Quercus mongolica - Betula schmidtii com. were distributed in higher altitude and precipitation area than others. Zabelia biflora - Astilboides tabularis subcom. has Spiraea chinensis, Zabelia biflora, Astilboides tabularis, Gymnocarpium jessoense, Saussurea mongolica, Larix kaempferi etc. as differential species, which was distributed in area with high amounts of sunlight exposure by human activities.

Results of Autologous Osteochondral Transplantation of the Ostochondral Lesion on the Talus: A Comparison Study between Medial Malleolar Osteotomy Approach and Anterior Arthrotomy Approach (거골의 골연골 병변에 대한 자가 골연골 이식술의 결과: 내과 절골 도달법과 전방 관절낭 절개 도달법의 비교)

  • Lee, Yong-Sik;Ahn, Gil-Yeong;Nam, Il-Hyun;Lee, Yeong-Hyun;Lee, Tae-Hun;Kim, Dae-Geun;Lee, Dong-Hyun
    • Journal of Korean Foot and Ankle Society
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    • v.21 no.4
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    • pp.139-143
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    • 2017
  • Purpose: Osteochondral lesion of the talus (OLT) has traditionally been treated using an autologous osteochondral graft via the medial malleolar approach. Here, we compare the traditional method with the anterior arthrotomy approach. Materials and Methods: Between January 2005 and June 2015, 24 cases of patients who received autologus osteochondral graft for OLT and with at least 2 years of follow-up were evaluated. They were divided into two groups; one group receiving autologous osteochondral graft via the medial malleolar osteotomy approach (group 1, n=9) and another group via the anterior arthrotomy approach (group 2, n=15). The clinical outcomes were assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) score. Results: In all cases, the size of the subchondral cyst of the talus decreased, if not disappeared on the final follow-up radiograph. All osteochondral grafts were united. The mean AOFAS score increased from 61.5 preoperatively to 84.9 at the final follow-up. The mean AOFAS score of group 1 increased from 60.3 preoperatively to 78.0 (p=0.007) at the final follow-up, and the mean AOFAS score of group 2 also increased from 62.2 to 89.1 (p=0.006). The AOFAS score was statistically better in group 2 than in group 1 (p=0.034) at the final follow-up. Conclusion: Autologous osteochondral graft of the OLT yields satisfactory radiologic and clinical outcomes. Especially, better clinical outcome was observed in the group using the anterior arthrotomy approach (group 2) than in the group using the medial malleolar osteotomy approach (group 1).

Benign Tumors of the Talar Body (거골 체부에 발생한 양성 종양)

  • Suh, Sung-Wook;Lee, Sang-Hoon;Kim, Han-Soo
    • The Journal of the Korean bone and joint tumor society
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    • v.8 no.3
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    • pp.76-82
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    • 2002
  • Purpose: Benign bone tumor of the talar body have rarely been evaluated according to the therapeutic methods because of the scarcity of their incidence. Here, we report our experience of 8 cases who were treated by using of posterior approach and curettage through the posterior process of the talus. Materials and Methods: Between February 1986 and October 2001, we experienced 8 cases of benign bone tumor occurring in the talar body. They included two osteoid osteomas, two giant cell tumors, one capillary hemangioma, one chondroblastoma, one simple bone cyst, and one osteochondroma. Their mean age was 22.1 years (ranging from 10 to 41 years). Mean follow-up period was 7.7 years (ranging from 1 to 16 years). All patients were treated by using of posterior approach. Two osteoid osteomas and one osteochondroma were treated by excision of tumors. Other cases were treated with curettage through the cortical window on the posterior process of the talus. Results: There was no recurrence during the follow-up period. one infection occurred. Except this case, all patients had no pain in weight-bearing, and complete range of movement at the ankle joint was reserved in each case. Conclusion: In this study, we suppose that posterior approach to the talar body may be a safe method with minimal damage of normal tissues and sufficient of curettage is capable through the cortical window on the posterior process of the talus.

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