Osteochondral lesions of the talus (OLTs) occur infrequently and are missed at the initial presentation in up to 67% of cases. Probably more than 1500 OLTs have been reported in published studies, of which, thus far, only 5 cases have been an inverted anterolateral OLT. An anterolateral OLT results from a hypersupination trauma, in which the talar dome is caught behind the fibula. Apparently, if the forces are large enough a " flip of the coin" phenomenon occurs, causing the fragment to invert 180° upside down. We present the case of a young female patient with an inverted OLT that was treated with open reduction and internal fixation using bioabsorbable pins. Follow-up radiographs and computed tomography showed a congruent joint and complete healing of the osteochondral fragment. At the short-term follow-up visit, the functional outcome was promising.

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doi.org/10.1053/j.jfas.2011.04.003, hdl.handle.net/1765/25648
Surgery and Traumatology
The Journal of Foot & Ankle Surgery
Erasmus MC: University Medical Center Rotterdam

Schepers, T., de Rooij, P., van Lieshout, E., & Patka, P. (2011). Reinsertion of an inverted osteochondral lesion of the talus: A case report. The Journal of Foot & Ankle Surgery, 50(4), 486–489. doi:10.1053/j.jfas.2011.04.003