Arthroscopic treatment of transchondral talar dome fractures: a long-term follow-up study.

Arthroscopic treatment of transchondral talar dome fractures allows accurate visualization and debridement of the lesion with less postoperative morbidity and earlier mobilization than arthrotomy. Although many studies document the results of open treatment, no reports of long-term results of arthroscopic treatment of these fractures have been published. We reviewed the results in 12 patients who had arthroscopic excision and curettage of a transchondral talar dome fracture and had an average of 10.1 years of follow up (range, 8.1 to 13.9 years). There were 5 medial and 7 lateral lesions. According to the four-stage classification of Berndt and Harty, 2 were stage II; 8 were stage III; and 2 were stage IV. All patients were evaluated with a subjective questionnaire, ankle radiographs, and a physical examination. The long-term subjective and objective results were good or excellent in 10, fair in 1, and poor in 1 patient. All patients' radiographs showed residual subchondral changes at the site of the original lesion, but minimal to no degenerative changes. Patients who are treated with arthroscopic debridement and curettage for transchondral talar dome fractures achieve a predictably high percentage of successful results with low morbidity.