Osteochondral lesions of the distal tibial plafond (OLTP) are rare and far less common than osteochondral lesions of the talus. CT arthrograms can be utilised for diagnostic injections as well for the quantification of cartilage thickness. Eur J Orthop Surg Traumatol. OBJECTIVES: Osteochondral lesions of the distal tibial plafond (OLTP) are rare and far less common than osteochondral lesions of the talus. In case the ankle is stable then you only will see the most anterior part of the defect. Clipboard, Search History, and several other advanced features are temporarily unavailable. If treatment refractory, consider increasing the intensity of EX/RP and/or level of care (i.e., intensive outpatient care, residential EX/RP program); somatic therapies (transcranial magnetic stimulation); or neurosurgical interventions (deep brain stimulation [DBS] or ablative procedures). Usuelli, FG, Di Silvestri, CA, D’Ambrosi, R, Maccario, C, Tan, EW. American Orthopaedic Foot & Ankle Society, Clinical Outcomes of Osteochondral Lesions of the Tibial Plafond Following Arthroscopic Microfracture, Athanasiou, KA, Niederauer, GG, Schenck, RC. Osteochondritis dissecans of the talar articular surface of the ankle joint has been well described. Though all the patients in this study were able to return to sports activity after the surgery, the postoperative level of sports activity was significantly lower than their preoperative level. Even with proper treatment… Footnote: (a) An illustration in the mid-sagittal plane is demonstrating the involved anterior joint capsule (circle) with associated osteophytes from the anterior tibial plafond and anterior talar neck. The Evolution of ACI for Surgical Treatment … 1 Patients frequently have pain, impaired ankle function, and decreased general health status. tibial plafond was located and marked on the skin utilizing the intraoperative fluoroscopy. … Chart review revealed that all subjects had ankle pain at time of MRI examination. Treatment: Nonoperative . Li, H, Hua, Y, Li, H, Li, S, Ma, K, Chen, S. Martin, RL, Irrgang, JJ, Burdett, RG, Conti, SF, Van Swearingen, JM. Of these, only one was a ‘kissing’ lesion. We report the imaging characteristics of osteochondritis dissecans of the tibial articular surface (tibial plafond). Abstract and Figures Background: Osteochondral lesions (OCLs) of the tibial plafond (OLTPs) are rare, and few studies provide treatment recommendations. The artery of the tarsal canal, which arises from the posterior tibial artery, and the tarsal sinus artery, which arises from the lateral tarsal artery or peroneal perforating branch of the peroneal artery, form an anastomosis supplying the inferior talus and talar neck. If only … Fractures of the tibial plafond. Depending on the type of injury, immobilization may be initiated with the use of a short leg cast or removable walking boot to protect the talus. This is a retrospective study of the radiographs, hospital charts, and clinic charts of 12 patients with 13 pilon fractures who were treated by the senior authors between 1989 and 1992 at their institution. The aim of treatment for Tibial Plafond Fracture is stable fixation of the metaphysis to the diaphysis and reestablishment of articular congruity in a satisfactory alignment. Sign in here to access free tools such as favourites and alerts, or to access personal subscriptions, If you have access to journal content via a university, library or employer, sign in here, Research off-campus without worrying about access issues. stable fracture patterns without articular surface displacement; critically ill or nonambulatory patients; significant risk of skin problems (diabetes, vascular disease, neuropathy) technique. This product could help you, Accessing resources off campus can be a challenge. Hoch, JM, Legner, JL, Lorete, C, Hoch, MC. 4,18 The term pilon fracture was first used in 1911 by Destot, who likened the distal tibia to a pestle. OCD Talus and Ankle Internet resources relating to Osteochondritis Dissecans affecting the Talus & Tibial Plafond [OCOSH Code: C05.116.791.668_BD_OC_OCD_T] In summary, we present a unique option for treatment of an OCD lesion of the tibial plateau with subchondral injection of calcium phosphate. Of these, only one was a ;kissing' lesion. Criteria for treatment … Literature data do not report clinical records with significant number of cases and follow-up. Access to society journal content varies across our titles. Conclusions: Tibial pilon fractures: a comparative clinical study of management techniques and results. It is the most common cause of an intra-articular loose body in adolescents. 27443_van Bergen.indd 21 27-11-13 09:23. Introduction:Osteochondral lesions of the tibial plafond account for approximately 2.6% of osteochondral lesions in the ankle. The level of sports activity after the surgery was significantly lower than their level before the surgery (P = .012). Download : Download video (35MB) Video 1. Tibial plafond fractures occur just above the ankle joint and involve that critical cartilage surface of the ankle. Material and methods: We assigned 9 zones to the distal tibial plafond … Case Presentation:A 17-year-old male competitive soccer player presented with a 6-7 month history of … A pilon fracture is an intraarticular fracture of the distal tibia. In a recent study, CT … Fractures of the distal tibial plafond are also termed pilon fractures to describe the high energy axial compression force of the tibia as it acts as a pestle, driving vertically into the talus. These fractures make up 5% to 7% of all tibial fractures. From there you can work posterior. Unfallchirurg. Arthroscopic microfracture provided satisfactory clinical outcomes for osteochondral lesions of the tibial plafond. Exclusion criteria were: age < 18 or > 50 years, patients with severe osteoarthritis (stage III according to Van Dijk classification), presence of kissing lesions of the ankle and patients with rheumatoid or hemophilic arthritis. The treatment of choice for TH has historically been biased towards amputation, though that does depend on the severity of the deformity. Treatment: Nonoperative . Pilon fractures may also … 2019 Aug 1;8(8):e875-e881. 2012 Aug;33(8):662-8. doi: 10.3113/FAI.2012.0662. 16 The periosteum at the level of the intended osteotomy is marked. Six of 38 ankles had both a talar osteochondral lesion and an OLTP. tibial plafond. We report the imaging characteristics of osteochondritis dissecans of the tibial articular surface (tibial plafond). Simply select your manager software from the list below and click on download. [Source 19)] Anteromedial … Contact us if you experience any difficulty logging in. Evolving treatment concepts for the pilon fracture. In my experience these lesions have a good healing potential without developing a loose body. Objectives: If you bring the ankle in forced plantar flexion you will see the defect. The superior surface of the talar body articulates with the tibial plafond, and the articular surface extends medially and laterally to articulate with the malleoli. 2009;30(9):900–3. The high incidence of good outcome in our series indicates that the one-step BMDCT could be a valid option for the treatment of this rare type of lesions. Presenting symptoms are often vague, and lesions may not always be visible on initial radiographs, which may lead to delayed treatment … Methods: You can be signed in via any or all of the methods shown below at the same time. Results: This technique is an effective treatment option for tibial pilon fractures. AOFAS members have access to this journal as part of their membership. Epub 2017 Jul 29. Some society journals require you to create a personal profile, then activate your society account, You are adding the following journals to your email alerts, Did you struggle to get access to this article? 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