Vascularized Bone Autograft for the Treatment of Chondroblastoma of the Talus at Imminent Risk of Joint Breakdown: Three Case Reports |
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Authors: | Joe Wagener Christine Schweizer Tamara Horn Lang Lukas Zwicky Dirk Johannes Schaefer Beat Hintermann |
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Institution: | 1. Attending Surgeon, Clinic of Orthopaedic Surgery, Kantonsspital Baselland, Liestal, Switzerland;2. Research Associate, Clinic of Orthopaedic Surgery, Kantonsspital Baselland, Liestal, Switzerland;3. Professor, Plastic Surgeon, University Hospital, Basel, Switzerland;4. Professor, Associate Professor, and Chair, Clinic of Orthopaedic Surgery, Kantonsspital Baselland, Liestal, Switzerland |
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Abstract: | Surgical treatment options in a chondroblastoma of the talus breaching the subchondral layer with imminent risk of talar collapse in the weightbearing area are limited. A joint-preserving surgery should be advocated. Because current treatment options such as curettage, cryosurgery, or radiofrequency ablation may not be able to prevent a talar dome breakdown in large defects, nonvascularized bone grafting has been advocated to fill the void. To overcome the lack of vitality, a vascularized bone autograft might be an attractive alternative. We present 3 cases where a large talar defect owing to a chondroblastoma was treated with a vascularized bone autograft. In 1 of the cases, a free microvascular iliac crest bone graft was used, whereas in the other 2 cases, a vascularized graft was harvested from the medial femoral condyle. Computed tomographic scans demonstrated a stable incorporation of the graft in all cases. All patients were highly satisfied with the obtained results and showed a clinical functional outcome similar to the contralateral foot after 36, 60, and 72 months. At the latest radiographic follow-up, no evidence of recurrence was observed. In conclusion, a free vascularized bone autograft can be used to treat a large talar defect owing to chondroblastoma in young patients. |
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Keywords: | 4 ankle benign bone tumor iliac crest medial femoral condyle talar defect |
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