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Curettage and Artificial Bone Graft Using Chevron Osteotomy for Bone Tumor of the Talus: A Report of Three Cases
Yoshiro Yoshikawa1, Hiromichi Oshiro1, Yuta Miyashi1
1Department of Orthopedic Surgery, Graduate School of Medicine, University of the Ryukyus, Ginowan, JPN.
Abstract:
Primary talar bone tumors are rare. Surgical intervention on talar bone tumors is often challenging, even though most lesions are benign. Due to its unique anatomical and biomechanical characteristics, this surgical approach requires careful consideration. Although most benign talar tumors can be treated with curettage alone, insufficient visualization increases the risk of recurrence, making the selection of an appropriate surgical approach crucial. We performed a chevron-type medial malleolar osteotomy, a technique widely used for its excellent exposure and stability, to manage talar tumors. Herein, we report three cases of benign talar tumors that were successfully treated with chevron-type medial malleolar osteotomy. Case 1, with a giant cell tumor of the bone (GCTB), experienced recurrence after initial curettage but was managed effectively with improved exposure using chevron-type medial malleolar osteotomy. Using the chevron-type osteotomy, case 2 and 3 patients with aneurysmal bone cysts (ABC) and GCTB, respectively, had no recurrence or complications. The medial malleolus was osteotomized in a reverse V-shape while preserving the deltoid ligament and was flipped distally for exposure. This technique offers excellent visualization and stability, suggesting its utility in managing talar tumors. This three-case series is the first to report the use of a chevron-type medial malleolar osteotomy for managing talar bone tumors, potentially aiding the surgical management of talar tumors, particularly those involving the talar dome.
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