Osteochondral lesions of the talar dome

Description: Osteochondral lesions were first described by Konig in 1888. He theorized that spontaneous necrosis was a causative factor for this condition. In 1922, Kappis described osteochondral lesions in the talus. Rendu,in a report published in 1932 describing intraarticular fractures of the talus, was the first to propose that these lesions may have a traumatic etiology. In 1959, Berndt and Harty concluded that these osteochondral lesions of the talus were, in fact, transchondral fractures caused by trauma.
Osteochondral lesions of the talus (OLT) are often painful and frequently cause recurrent synovitis and altered joint mechanics. The incidence of OLT has been reported to range from 0.9% of all talar fractures5 to 6.5% of ankle sprains. A prospective study looked at 288 ankle fractures that needed open reduction internal fixation and found that 79.2% had cartilage lesions when evaluated arthroscopically.
Etiology Many different terms have been used to describe these defects of talar articular cartilage including transchondral fracture, osteochondral fracture, osteochondritis dissecans, talar dome fracture, and flaked fracture.
Osteochondral lesions of the talar dome. Finger A, Sheskier SC. Bull Hosp Jt Dis. 2003;61(3-4):155-9. Full text available