KMID : 0361620170520040310
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Journal of the Korean Orthopaedic Association 2017 Volume.52 No. 4 p.310 ~ p.318
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Conservative Treatment for Juvenile Osteochondritis Dissecans of the Talus
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Kim Hui-Taek
Park Kun-Bo Seo Chang-Hyo Ahn Tae-Young Kim In-Hee
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Abstract
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Purpose: We compared the results between conservative and surgical treatment methods in a group of children and adolescents with osteochondritis dissecans of the talus.
Materials and Methods: A total of 24 patients (31 ankles), who were younger than 18 years old, were included in this study. Group 1 consisted of 14 ankles (mean age at the time of treatment was 13.0 years) treated conservatively. Group 2 consisted 17 ankles (mean age at the time of treatment was 15.1 years) treated surgically. According to the Berndt and Harty classification, there were 6 ankles in class I, 4 in class II, 3 in class III, and 1 in class IV in group 1; 1 ankle in class I, 9 in class II, and 7 in class III in group 2. In group 1, there were 13 medial lesions and 1 lateral lesion; and in group 2, there were 14 medial lesions and 3 lateral lesions. The mean follow-up period was 31.9 months for group 1 and 28.9 months for group 2. Clinical and radiologic results were analyzed using the American Orthopaedic Foot and Ankle Society (AOFAS) score and the classification by Higuera et al.
Results: The mean AOFAS clinical score was 91.4 in group 1 and 87.5 in group 2. According to the classification by Higuera et al., regarding clinical results, there were 6 excellent, 7 good, and 1 fair in group 1, and 5 excellent, 2 good, and 10 fair in group 2. As for radiological results, there were 13 good and 1 fair in group 1, and 10 good and 7 fair in group 2. There was no statistical difference between the two groups.
Conclusion: Conservative treatment provided satisfactory results for osteochondritis dissecans of the talus in children and adolescents.
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KEYWORD
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talus, osteochondritis dissecans
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