[Osteochondral lesions of the talus]

The study of 102 cases of talar dome osteochondral lesions allows to class them in different categories: The lateral lesions are almost always osteochondral fractures. They are often discovered as fresh lesions. Frequently the ankle lateral ligament is also injured. They can be immobilized or fixed using a screw. In a second category, where the lesions are medial, it has been impossible to find any argument in favour of a traumatic origin. Most of the patients are young, still growing up. The prognosis is favorable. In the third category, the lesions are also medial, but their aspects are different. We cannot deny the traumatic origin, but we cannot demonstrate it, and the explanation of these lesions are hypothetical. Here the lesions are often severe, the surgical treatment is necessary with good clinic results in spite of radiological signs persistence and of late arthrosis evolution.