Talar-sided osteochondral lesion of the subtalar joint following the intra-articular calcaneal fracture: study via a modified computed tomography mapping analysis
- 39 Downloads
This study is to report the prevalence of osteochondral lesions in subtalar joint following intra-articular calcaneal fracture, including the relationship between fracture severity and lesion characteristics, using modified computed tomography (CT) mapping analysis.
Thirty patients with intra-articular calcaneal fracture who were preoperatively imaged with modified CT mapping analysis were recruited. The presence of talar-sided osteochondral lesions (OLTS) of subtalar joint was noted with lesion area defined by Akiyama’s mapping classification. Lesion severity was assessed via Ferkel’s classification, and fracture severity via Sanders’ classification.
Lesions were found in 28 patients (93.3%), mostly at anterior [16 (57.1%) lesions] or central [13 (46.4%) lesions] areas of posterior talar facet. Most common grade of lesion severity was grade I (mild) seen in 24 (80%) patients. Most fractures were classified as Sanders’ grade III and IV with 12 (40%) and 12 (40%) patients noted, respectively. High severity of fracture denoted by Sanders’ grade IV showed a trend of higher prevalence of OLTS at anterior and central sites of posterior talar facet (P = 0.181). Lesion severity was significantly higher in patients with double lesions than patients with single lesions (P = 0.005). However, OLTS were not significantly related with osteoarthritic changes in follow-up radiographs (P > 0.05).
The prevalence of OLTS is very high following intra-articular calcaneal fractures. Most lesions occur at anterior or central area of posterior talar facet and are more likely to occur in patients with higher fracture severity. Lesion severity was significantly higher in patients with double lesions than patients with single lesions.
KeywordsCalcaneus Fracture Osteochondral Talus Arthritis Computed tomography
The author would like to propose special thanks to Drs. Suebsakul Nangnual, Saowabhak Nitayavardhana, and Rakop Taveesuksiri (research assistants) for their helps in the present study.
Compliance with ethical standards
Conflict of interest
Dr. Angthong reports personal fees from Menarini, personal fees from Amgen, personal fees from Smith & Nephew, outside the submitted work; Dr. Veljkovic reports grants from Wright medical, grants from Zimmer, grants from Acumed, grants from Ferring, grants from Synthes, grants from Arthrex, outside the submitted work; Dr. Angthong has nothing to disclose; Dr. Rajbhandari has nothing to disclose.
- 1.Harnroongroj T, Chuckpaiwong B, Angthong C, Nanakorn P, Sudjai N, Harnroongroj T (2012) Displaced articular calcaneus fractures: classification and fracture scores: a preliminary study. J Med Assoc Thai 95(3):366–377Google Scholar
- 6.Ferkel RD, Sgaglione NA, Del Pizzo W (1990) Arthroscopic treatment of osteochondral lesions of the talus: techinque and results. Orthop Trans 14:172–173Google Scholar
- 8.Akiyama K, Sakai T, Sugimoto N, Yoshikawa H, Sugamoto K (2012) Three-dimensional distribution of articular cartilage thickness in the elderly talus and calcaneus analyzing the subchondral bone plate density. Osteoarthr Cartil 20:296–304. https://doi.org/10.1016/j.joca.2011.12.014 CrossRefGoogle Scholar
- 10.Angthong C, Atikomchaiwong A, Yoshimura I et al (2014) Does the addition of computed tomography to computed radiography provide more value to final outcomes and treatment decisions in displaced intra-articular calcaneal fractures? J Med Assoc Thai 97(Suppl 9):S1–S9Google Scholar
- 16.Sanders R, Vaupel ZM, Erdogan M, Downes K (2014) Operative treatment of displaced intraarticular calcaneal fractures: long-term (10–20 Years) results in 108 fractures using a prognostic CT classification. J Orthop Trauma 28:551–563. https://doi.org/10.1097/BOT.0000000000000169 CrossRefGoogle Scholar