Trans-chondral fractures of the talus: a review of 64 surgical cases.

The authors present a retrospective study of 67 transchondral fractures of the talus in 64 patients that were treated surgically. A thorough literature review, physiology of articular cartilage and subchondral bone repair, and a comprehensive treatment of transchondral lesions are presented. Consideration is given to surgical approaches that require fibular and medial malleolar osteotomy, and to open reduction with internal fixation of the transchondral fractures. A new, practical, radiographic classification with appropriate terminology is proposed which acknowledges recent fractures from subsequent avascular necrosis of the lesions.