title: Reinsertion of an inverted osteochondral lesion of the talus: a case report.
abstract: Osteochondral lesions of the talus (OLTs) occur infrequently and are missed at the initial presentation in up to 67% of cases. Probably more than 1500 OLTs have been reported in published studies, of which, thus far, only 5 cases have been an inverted anterolateral OLT. An anterolateral OLT results from a hypersupination trauma, in which the talar dome is caught behind the fibula. Apparently, if the forces are large enough a "flip of the coin" phenomenon occurs, causing the fragment to invert 180° upside down. We present the case of a young female patient with an inverted OLT that was treated with open reduction and internal fixation using bioabsorbable pins. Follow-up radiographs and computed tomography showed a congruent joint and complete healing of the osteochondral fragment. At the short-term follow-up visit, the functional outcome was promising.
authors.affiliation: Department of Surgery-Traumatology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, The Netherlands. t.schepers@erasmusmc.nl
authors.forename: Tim
authors.initials: T
authors.lastname: Schepers
authors.forename: Philippe P
authors.initials: PP
authors.lastname: De Rooij
authors.forename: Esther M M
authors.initials: EM
authors.lastname: Van Lieshout
authors.forename: Peter
authors.initials: P
authors.lastname: Patka
mesh_terms: D016512:Ankle Injuries / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D000843:Ankle Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D001858:Bone Nails; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods*; D005597:Fractures, Open / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D010008:Osteochondritis Dissecans / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D012092:Replantation / Q000379:methods*; D013628:Talus / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D055815:Young Adult