Osteocondritis disecante de astrágaloa propósito de un caso clínico tratado mediante técnica mínimamente invasiva

Abstract

Osteochondritis dissecans of the talus in adults is quite common; on the contrary, the juvenile forms are unusual and are usually associated with sportive activities. It is a subject not very studied yet, because the majority of the treatment guides and studies are based on adult cases. The treatment in juvenile forms is still controversial. A conservative treatment of the osteochondritis dissecans of the talus is usually indicated in I and II stage lesions of the Berndt and Harty classification. In these stages, good results have been observed in knee and elbow, nevertheless, in the talus, the studies have shown big percentage of failure. The aim of a surgical treatment of this type of lesions with intact cartilage is the vascularization of the damaged zone using vascular channels formation by drilling. However, dorsomedial lesions of the talus are frequently inaccessible to anterior arthroscopic drilling without damaging the intact cartilage. This is why retrograde drilling techniques have been developed. A clinical case of a child presenting osteocondritis dissecans of the talus, in medial location is presented. A conservative treatment was at first attempted and due to the failure of the above mentioned treatment, a surgical approach by retrograde drilling was performed with an arthroscopic technique.