Central talar OCD

Osteochondral Defects

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

A 37-year-old male patient with complaints of the right ankle.

History and previous treatment:

Was doing martial arts 14 months ago and sustained a comminutted talar body fracture which remained undiagnosed for 12 months (normal X-rays). He had MRI which showed healing talar body fracture with OCD.

Current complaints:

Deep ankle pain, constant, worse with loading of the foot, and also present at night. Feels a "click" and "give way after pain".

Physical examination:

High medial arch, neutral heel, limited eversion. Tender anterolateral talus. Slight laxity to ATFL.


[Picture 1 + 2]

Additional investigation (CT/MRI):
[Picture 3 + 4]


Case summary:

37-year-old male with a central talar dome OCD.

Question(s) to this case:

Does he require medial malleolar osteotomy for treatment?


A CT scan is needed for preoperative planning to determine the exact size and location of the lesion. If the OCD needs treatment, then for 99% you should be able to reach it in plantar flexion from the front (no osteotomy needed).