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            [0] => Traumatic osteochondral lesion of the talus: A case report and review of the literature
        )

    [etablissement] => Array
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            [0] => service de chirurgie orthopedique et traumatologie hopital Taher Maamouri nabeul
        )

    [nom] => Array
        (
            [0] => chamakh
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    [prenom] => Array
        (
            [0] => mohsen
        )

    [email] => Array
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            [0] => mohsenchamakh2@gmail.com
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            [0] => 24545007
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            [0] => 
 
Nom prénom: chamakh mohsen
Email: mohsenchamakh2@gmail.com
Hôpital: taher maamouri nabeul

 
Nom prénom: mohamed jlidi
Email: 
Hôpital: taher maamouri nabeul

 
Nom prénom: dhiaeddine baccouche
Email: 
Hôpital: taher maamouri nabeul

 
Nom prénom: khalil jellali
Email: 
Hôpital: taher maamouri nabeul

 
Nom prénom: daas selim
Email: 
Hôpital: taher maamouri nabeul

        )

    [mots_cles] => Array
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            [0] => talus , osteochondral lesion , ankle;

        )

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            [0] => 3663
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            [0] => https://www.sotcot.tn/wp-content/uploads/gravity_forms/1-734bfe19ec36a1528718899bf7a2927f/2024/03/abstract-dome-astragalien-final1.docx
        )

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            [0] => medtaghouti96@gmail.com
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    [specialite] => Array
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            [0] => Chirurgie orthopédique et traumatologique
        )

    [pays] => Array
        (
            [0] => Tunisie
        )

    [texte_abs] => Array
        (
            [0] => Introduction:

Osteochondral lesions of the talus (OLTs) occur infrequently and are missed at the initial presentation in up to 67% of cases. The etiology of chronic osteochondral lesions is still debated, because a significant percentage of patients with osteochondral lesions report no initial trauma. However, in a review by Flick and Gould of more than 500 patients with OLTs, 98% of the lateral dome lesions and 70% of the medial dome lesions were associated with a history of acute trauma. A special presentation of a Berndt-Harty grade 4 OLT is the “inverted osteochondral fragment”. This type of lesion typically occurs on the anterolateral part of the talus and is of traumatic origin, and a surgical management is generally preferred. 
We present the case of inverted OLT treated by open reductionand internal fixation.
Case report:
We report the case of a 31-year-old patient who consulted the emergency department for trauma to the left ankle following a domestic accident.Clinical examination showed swelling and diffuses tenderness over the left ankle. The skinwas intact and there were no associated neuro-vascular complications inthe left lower limb.
X ray antero-posterior and lateral views of the left ankle showeda loose fragment originate from the antero-medial corner of the talus dome. It was typeIV according to Berndt and Harty classification. For a better fracture assessment and preoperative planning, a computed tomography(CT) scan was also performed confirming the tear fracture of the antero-medial corner of the dome of the talus with displacement of the bone anterior fragment to the fibula.
The patient was operated under antero-medial approach. Treatment was made by open reduction and internal fixation with Scarf. The lower left limb was immobilized in posterior plaster splint. 
At the last follow-up, the patient walked without crutches. The ankle joint range of motion was 20° of dorsiflexion and 30° of active plantar flexion. No avascular necrosis of talus was seen.
Conclusion:
The reinsertion of the acute traumatic OLT with PDS Scarf screw is a valuable asset in the treatment of OLTs, especially in the inverted lesions, and good to excellent results can be obtained at short-term follow-up.
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