Talar cystic lesion


Description of patient (type of occupation, indication of age, intensity of sport):

Female, 17 years old, sedentary profession.

History and previous treatment:

Insidious pain in the ankle. No trauma.

Current complaints:

Pain when uses high heeled shoes. Limitation of plantar flexion on the left ankle.

Physical examination:

Neutral alignment. Important limitation of the plantar flexion on the left ankle. Negative drawer test.


Talar cystic lesion.

Additional investigation (CT/MRI):
CT: 2 cm posteromedial osteochondral lesion.
[Picture 1 -3]


Case summary:

Talar cystic lesion in a 17 years old female patient.

Question(s) to this case:

The best option is an open procedure or arthroscopic? Anterior or posterior arthroscopy?


Large lesion with secundary cyst below the lesion, which means that the fragment does take a significant part of the load.
My advice is to go for a lift-drill-fill-fix procedure. Leave the fragment and secure it to the talus. If she has no laxity of the ankle ligaments I am afraid the aproach in this case has to be by means of a medial malleolar osteotomy.