Osteochondritis dissecans tali: Diagnosis and therapy

Abstract

Osteochondritis dissecans tali (ODT) is still considered a joint disease and is therefore treated primarily as a problem of the joint. It has been suggested that it should be considered as a separate disease resulting from an intra-osseous ganglion. ODT must be distinguished from traumatic flake fractures. By treating ODT as a bone problem and carrying out extra-articular debridement of the ganglion and a cancellous bone graft we achieved out of eight cases, four excellent, three good and one poor result. In all cases the cancellous bone graft was consolidated and the joints were congruent and non-arthritic. The diagnostic technique is also discussed herein: the most useful method is conventional radiography. If additional information is needed about size and location of the lesion, a computed tomography (CT) scan should be used.