Journal of orthopaedic surgery (Hong Kong) · 2012
Conservative treatment for juvenile osteochondritis dissecans of the talus.
СтатьяНазвание и аннотация: Перевод в очереди
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Lam Kai Yet, Siow Hua Ming
Аннотация
PURPOSE: To assess outcome of 6 juvenile patients with osteochondritis dissecans (OCD) of the ankle treated conservatively.
METHODS: Records of 4 males and one female aged 10.8 to 14.1 (mean, 12.3) years who underwent cast immobilisation and/or restriction of physical activities for OCD of the talus (4 on the left and 2 on the right) were reviewed. OCD lesions were graded using the Berndt and Harty classification. Functional outcome was assessed using the ankle-hindfoot score of the American Orthopaedic Foot and Ankle Society. Clinical and radiographic outcomes were assessed according to the Higuera classification.
RESULTS: The mean follow-up period was 30.5 (range, 11-63) months. The mean ankle-hindfoot score was 90 (range, 86-100). Radiological resolution of OCD was noted in 2 ankles, although all ankles showed some degree of healing. All patients had resolution of pain after a mean of 7 (range, 3-12) months. According to the Higuera classification, clinical outcome was excellent in one and good in 5 ankles, whereas radiological outcome was excellent in 2, good in 2, and fair in 2 ankles. In one patient, the OCD of the right posteromedial talar dome resolved spontaneously.
CONCLUSION: Almost all patients achieved good functional outcome after conservative management, regardless of the presence of radiological evidence of healing. Surgery should only be performed if the OCD is unstable.
METHODS: Records of 4 males and one female aged 10.8 to 14.1 (mean, 12.3) years who underwent cast immobilisation and/or restriction of physical activities for OCD of the talus (4 on the left and 2 on the right) were reviewed. OCD lesions were graded using the Berndt and Harty classification. Functional outcome was assessed using the ankle-hindfoot score of the American Orthopaedic Foot and Ankle Society. Clinical and radiographic outcomes were assessed according to the Higuera classification.
RESULTS: The mean follow-up period was 30.5 (range, 11-63) months. The mean ankle-hindfoot score was 90 (range, 86-100). Radiological resolution of OCD was noted in 2 ankles, although all ankles showed some degree of healing. All patients had resolution of pain after a mean of 7 (range, 3-12) months. According to the Higuera classification, clinical outcome was excellent in one and good in 5 ankles, whereas radiological outcome was excellent in 2, good in 2, and fair in 2 ankles. In one patient, the OCD of the right posteromedial talar dome resolved spontaneously.
CONCLUSION: Almost all patients achieved good functional outcome after conservative management, regardless of the presence of radiological evidence of healing. Surgery should only be performed if the OCD is unstable.