The 'LIFT' lesion: lateral inverted osteochondral fracture of the talus
| Autor: | Bradley J. Dunlap, Richard D. Ferkel, Gregory R. Applegate |
|---|---|
| Rok vydání: | 2012 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Radiography Physical examination Talus Lesion Arthroscopy Fractures Bone Young Adult medicine Humans Orthopedics and Sports Medicine Ankle Injuries Child Physical Examination Orthodontics medicine.diagnostic_test business.industry Magnetic resonance imaging Magnetic Resonance Imaging Surgery Lateral inverted medicine.anatomical_structure Treatment Outcome Athletic Injuries Ligament Female Ankle medicine.symptom business Tomography X-Ray Computed Ankle Joint Follow-Up Studies |
| Zdroj: | Arthroscopy : the journal of arthroscopicrelated surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association. 29(11) |
| ISSN: | 1526-3231 |
| Popis: | Purpose The purpose of this study was to assess a series of lateral inverted osteochondral fractures of the talus. Methods Over a 17-year period, 10 patients with an acute lateral inverted osteochondral fracture of the talus after an inversion injury to the ankle were identified. Diagnosis was made by physical examination, radiographs, magnetic resonance imaging, and/or computed tomography scan. Arthroscopy was initially performed on all patients. All patients had an inverted osteochondral fragment. In 8 of 10 patients the fragment was reattached in an open manner in conjunction with lateral ligament reefing. The fragment was excised in 2 patients. The mean age of the patients was 17.2 years. They were evaluated with the Single Assessment Numeric Evaluation, American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale, modified Weber score, Berndt and Harty score, and Short Form 36 version 2 score. Physical and radiographic examination was also performed. The mean time to follow-up was 112.3 months (9.3 years). Results The mean American Orthopaedic Foot and Ankle Society score improved from 18.9 preoperatively to 86.9 postoperatively ( P ≤ .0001). The mean Single Assessment Numeric Evaluation and modified Weber scores were 81.6 and 81.5, respectively. On the Berndt and Harty scale, 6 patients had a good to excellent rating; 3, fair; and 1, poor. The mean Short Form 36 version 2 scores corresponded to national averages for healthy populations. Mean loss of motion for dorsiflexion and plantarflexion was 6.8° and 3.0°, respectively, when compared with the contralateral side. All patients showed some osteophyte formation on follow-up radiographs. Conclusions An inverted osteochondral fracture of the lateral talus (lateral, inverted, fracture, talus [LIFT lesion]) can occur after a twisting injury to the ankle. Clinical suspicion should be high, especially in the younger athlete. This injury can be successfully managed with a combined arthroscopic and open approach. Level of Evidence Level IV, therapeutic case series. |
| Databáze: | OpenAIRE |
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