Osteochondral fracture?

Posterior Ankle Pathology

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

45 year old male. ankle inversion injury 3 days ago

History and previous treatment:

no history

Current complaints:

pain obviously

Physical examination:

not yet examined


[Picture 1 + 2]
OCL medial dome

Additional investigation (CT/MRI):
[Picture 3 + 4]
OCL with fragmentation?


Case summary:

45 year old male with ocl

Question(s) to this case:

do you think this is new or old finding? what would you do? scope? debride? fix through osteotomy? observe?


This is a preexisting OCD: there is osteofyte on talus and small cystic lesion (sagital reconstruction: posterior). The patient had no symptoms before: therefor stay conservative. If complaints of deep ankle pain persist then debridement and bone marrow stimulation