Bone contusions - are they really fractures? | MyFootShop.com mobil 1 synthetic grease vs red n tacky; unique military gifts; best residential soccer academies in usa; super mario rpg sunken ship walkthrough Sort by Popularity - Most Popular Movies and TV Shows tagged with keyword "sprained-ankle". Comments Off on Osteochondromas of the subtalar joint: A case study, Tagged chondroma, kissing lesion, Osteochondroma, talocalcaneal, on Osteochondromas of the subtalar joint: A case study, osteochondroma, chondroma, talocalcaneal, kissing lesion, Radiographic examination demonstrated complete joint space loss at the posterior subtalar facet with subchondral sclerosis and subchondral cyst formation as well as a large well-circumscribed exostosis posterior to the subtalar joint (Figure 1). A common symptom of ankle instability is the feeling of the ankle ready to give way. For complete information about the cookies we use, data we collect and how we process them, please check our, why was the suez canal important to britain, diameter and circumference of a soda can in cm, Msvs_version Not Set From Command Line Or Npm Config, Power Automate Get File Properties From Url. J Bone Joint Surg Am.
kissing contusion ankle It is very important to differentiate these conditions with the help of specific symptoms. Bruising. 2002 Nov;31(11):615-23. doi: 10.1007/s00256-002-0575-z. This case highlights how careful surgical planning can appropriately evaluate for any malignant transformation while preventing the recurrence of this lesion and mitigating its complications. Skin has bruises which are not due to bleeding beneath the skin but a result of internal bleeding in the bone. ankle inversion and dorsiflexion during axial load creates shearing of lateral talar dome and lateral OLT, ankle inversion, external rotation, and plantarflexion during axial load creates shearing of medial talar dome and medial OLT, possible repeitive microtrauma creates ischemic environment and loss of integrity of subchondral bone, leads to softening and disruption of overlying cartilage, among the thickest in the body (implications for osteochondral autografting), maintains tensile strength longer than femoral head with aging process, deltoid artery supplies majority of talar body and dome, ankle is a highly congruent mortise joint, oriented 15 degrees externally from midsagittal line of ankle, talus articulates with the medial malleolus medially, tibial plafond superiorly, posterior malleolus posteriorly, and fibula laterally, Berndt and Harty Radiographic Classification, Complete fragment detachment but not displaced, Cystic lesion within dome of talus with an intact roof on all view, Cystic lesion communication to talar dome surface, Open articular surface lesion with the overlying nondisplaced fragment, Cartilage injury with underlying fracture and surrounding bony edema, mechanical symptoms such as catching or locking, often limited secondary to pain or effusion, evaluate for ligamentous laxity or insufficiency, suspicion for OLT in setting of equivocal radiographs, helpful in evaluating subchondral bone and cysts, less reliable in purely cartilaginous lesions of nondisplaced OLTs, provides fine detail of lesions for pre-operative planning, persistent pain following injury, ankle sprains that do not heal with time, variable edema patterns, may overestimate degree of injury, unstable lesions show fluid deep to subchondral bone, predicts stability of lesion with 92% sensitivity, nondisplaced fragment with incomplete fracture, osteochondral grafting (osteochondral autograft transplantation, autologous chondrocyte implantation, bulk allograft), size > 1 cm and displaced lesions, shoulder lesions, salvage for failed marrow stimulation or drilling, period of immobilization in cast or boot for 6 weeks, followed by progressive weight bearing with physical therapy emphasizing peroneal strengthening, range of motion, and proprioceptive training, debridement of unstable cartilage flaps to create stable and contained defect using curettes or shaver, loose bodies and cartilage removed using shaver or grasper, microfracture awl placed perpendicular to surface and tapped into subchondral bone 2-4 mm deep, inflow stopped to allow fat or blood to emanate from holes, indicating adequate penetration, Kirschner wire can be passed using anterior portals, or transmalleolar for central or posterior lesions, talus dorsiflexed and plantar flex to necessitate only 1 transosseous passing of wire, articular cartilage delamination and graft failure, 65-90% improvement in patient reported outcomes, fibrocartilage formation at site of lesion in 60% of patients on second-look arthroscopy, no correlation noted with patient outcomes, evaluate cartilaginous surface for softening, dimpling with probe seen, Kirschner wire drilled from sinus tarsi into defect, fluoroscopy often helpful to confirm location, if bone grafting indicated, cannulated drill placed over K wire, dictated by location of OLT and concomitant procedures required (i.e. There was also underlying severe bone on bone degenerative change of the posterior facet with associated reactive edema within the talus and calcaneus (Figure 2). After growth plate closure there is typically no further growth of the lesions and the cartilage cap of osteochondroma mature to a maximal thickness of 2mm [5]. Bone is usually made of a hard, outer surface with a softer, spongy inner surface. Knee Surg Sports Traumatol Arthrosc. For knee joint bruises it is six months and only three months for ankle bruises. We present this case as an example of the chronic complications associated with osteochondral lesions in hopes of promoting earlier management. Materials and methods: To our knowledge, no detailed studies exist on bone bruises associated with osteochondral fractures in the ankle. Finally, physical therapy may help you learn to move in ways that wont aggravate your injuryask your doctor if this is relevant in your specific situation. Only six of the 12 talar fractures and none of the tibial fractures involving the 26 ankles were seen on conventional radiography. Contusion of left knee, initial encounter. For instance, if the anterior cruciate ligament were to rupture, the tibia can slide forward (subluxate) and impact the femoral condyle (a so-called kissing contusion). We hope understanding the chronic complications associated with these lesions can facilitate earlier management prior to the development of late arthritic changes. Figure C shows the corresponding MRI. Use an ice pack, or put crushed ice in a plastic bag. The bone bruise tends to heal within 60 days whereas the ligament will take much longer to heal. This leads to a severe blow on the knee joint, femur (thigh bone) and the tibia (shin bone). Wrist: Rheumatoid arthritis causes oedema of the bone marrow and affects the smaller joints of the body. T1 weighted method of MRI will show the bruise in the form of a decrease in bone intensity. Limping will also cause the ankle to have a lot more weight on it. Early surgical intervention has been advocated for metaphyseal or juxta-articular lesions to avoid complications with associated growth and deformity. Epub 2018 Feb 23. This is common in older females when there is existing bone weakness due to osteoporosis. S90.02XA is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
Recovering from an ankle sprain - Harvard Health Stress Fracture occurs when there is repeated and constant trauma to the bone. (. During his workup, an MRI shows a 1x1 cm lateral talar osteochondral defect (OCD). Only six of the 12 talar fractures and none of the tibial fractures involving the 26 ankles were seen on conventional radiography. Epub 2018 Feb 5. These contusions are generally found by magnetic resonance imaging and most cases are associated with ligamentous or menisceal injuries. June 25, 2022; 1 min read; california mustard plant; kikker 5150 with harley engine; kissing contusion knee radiology . Magnetic resonance imaging demonstrated bony excrescences at the posterior subtalar joint with disruption of the posterior facet articular surfaces. A T2 weighted scan or a fat suppressed type of MRI will show increased intensity. Rough first quarter for the Celtics who shot 9-for-23 from the field, committed five turnovers and lost Jaylen Brown for the game with a right ankle injury. A condition where the blood collects inbetween the cortical bone and the periosteum is called as subperiosteal haematoma. Sagittal T2-weighted image 1 year after injury reveals a subchondral cyst (arrow), an articular defect in the lateral tibial plateau, and a large knee effusion (arrowhead). Its function and structure make it vulnerable to injury, especially during activities like jumping and running. By logical extension, the instability of torn knee cartilage could be the source of this type of pain. Posttraumatic subchondral bone contusions and fractures of the talotibial joint: occurrence of kissing lesions. (iii)Impaction: In a joint cavity, if both the bones rub against each other, the articular surface tends to get damaged resulting in a bone bruise on both the surfaces. The 2023 edition of ICD-10-CM S80.02XA became effective on October 1, 2022. Post operatively the patient was treated with standard protocol for subtalar joint arthrodesis. Ankle sprains are a common cause of OLTs. The superficial deltoid ligaments appear intact. (55/225 (21.5%)). They are associated with joint pain and inflammation. The diagnosis can be done by an X-ray or MRI. Spine: Spinal arthritis or spondyloarthritis causes bone marrow oedema which is the diagnostic feature on an MRI. Traumatic injury to the ankle/foot (ankle sprain) or overuse is the main cause of this syndrome. PENNYSUE. A strain happens when a muscle or tendon is stretched too far or is partially torn. ankle sprain series: ankle: ankle sprain intro: Ankle Anatomy: ankle injury: geoff jenkins ankle injury: alabama ankle injury: sprained ankle: Katy Perry kissing in teenage dreams; Katy Perry; Katy Perry Hot; Katy Perry without makeup; freida Pinto hot; freida Pinto cool pics; freida Pinto on maxim; GET THE RIGHT SIZE FOR THE BEST FIT - Refer to our size chart to get the best fit. Osteochondromas of the subtalar joint: A case study, Management of an open crush fracture to the foot from a lawnmower injury: A case report, The clinical and patient centered outcomes following surgical correction of tailors bunion in an acute hospital based podiatric surgery service, Fluoroquinolone-induced Achilles tendinopathy A case report and management recommendations, Reconstruction of an Achilles rupture with 12 cm defect utilizing Achilles tendon allograft and calcaneal bone block: A case report, Congenital amniotic band constriction of the proximal tibia: A Yucatan project case report, Distal lower extremity manifestations in spina bifida patients of the Yucatan Peninsula: A 24-year retrospective case series, Management of a dislocated talar dome fracture with ankle arthrodiastasis and open reduction internal fixation: A case report, A case of recurrent hyperostotic macrodactyly. In 16 (11%) of the 146 ankles, the lesions were present in the opposing bones of the joint ("kissing" lesions). Bone bruise is present in this case but is not the cause of the pain. Radiographics 2000 ; 20 : 1407-1434. Copy and Paste Pain at the back of the ankle. Other examples of bone injuries include stress fractures, osteochondral fractures and a variety of different patterns of bone fractures. This takes only a few months. Pain Physician. baker's dozen, english muffin, kissing cousin, ragamuffin, second cousin 5 minor, more People also search for: injury, contusion, sprain, charley horse hamstring, stress fracture, ankle, herniated disc, bruise, more Use concussion in a sentence. 4,10,24 The absolute risk of ankle sprains had been estimated to be 1 per 1000 sports hours 23 and makes up a significant amount of lost playing time. Prognosis: After a knee joint bone bruise, the recovery time for atheletes is usually 6 months especially if the anterior cruciate ligament is torn. Butler JJ, Mercer NP, Hurley ET, Shimozono Y, Kennedy JG. You will also likely be advised to refrain from strenuous physical activity while you heal. Figure 4 Removal of the osteochondromas about the posterior aspect of the subtalar joint with demonstration of exposed subchondral bone. The bruise does not reach the surface of the joint and is generally mild in intensity. Finally, they can cause intra-articular loose body formation, ankle deformity, peroneal spastic flatfoot, limb length inequality or in adults with secondary arthritis [10]. Ankle Injury DL25. : Ice the knee for 20 minutes at a time, 3-4 times per day. One of the peculiarities that can develop in the adult with juxta-articular kissing lesions, especially in the lower extremity, is the proclivity towards arthrosis of the involved joint owing to abnormal contact stresses.
Bone contusions - Myfootshop.com foot and ankle blog Casado-Hernndez I, Becerro-de-Bengoa-Vallejo R, Losa-Iglesias ME, Santiago-Nuo F, Mazoteras-Pardo V, Lpez-Lpez D, Rodrguez-Sanz D, Calvo-Lobo C. Quant Imaging Med Surg. Only six of the 12 talar fractures and none of the tibial fractures involving the 26 ankles were seen on conventional radiography. (ii)Geographic: This type of bone bruise is comparatively bigger in size and more dense as compared to reticular bruise. A: Ha ha ha! The adjacent osteochondromas were then identified deep to the flexor hallucis longus, which was retracted medially to gain access to the lesions. A contusion (kun-TOO-zhun), or bruise, of the ankle is an injury to the skin and underlying tissue of the ankle. 1996 Jan;25(1):49-54. doi: 10.1007/s002560050031. Physical examination elicits pain with ankle dorsiflexion and plantarflexion, although subtalar motion is normal. Schematic drawing of talocrural joint injury in pronation (a) results in sprain of the medial collateral ligaments (brown) and lateral-sided OCL of the talar dome and/or kissing tibial lesion (orange zones), whereas injury in supination (b) causes sprain of the lateral ligaments and medial-sided OCL of the talar Severe locking or catching symptoms, where the ankle freezes up and will not bend, may indicate that there is a large osteochondral lesion or even a loose piece of cartilage or free bone within the joint. 2007;89(5):987-993. Lateral and Mortise views of the left ankle demonstrate severe subtalar joint space narrowing with a well circumscribed pedunculated osseous lesion projecting posteriorly from the subtalar joint.
kissing contusion ankle - xn--t8j4aa4nv33n0f7anh5atsw.com Orthop J Sports Med. A 21-year-old male reports right ankle pain after sustaining an inversion ankle injury 2 years ago. The discovery that bone contusion occurs during ACL ruptures was made by looking at MRIs of 81 patients .
Grizzlies' Brandon Clarke leaves game vs. Nuggets early after non Hi woud appreciate any opinons on this. Sprains heal faster, but it can take up to six weeks for a broken . of and in " a to was is ) ( for as on by he with 's that at from his it an were are which this also be has or : had first one their its new after but who not they have The incidence has been reported to be between 2 and 7 per 1000 person-years. To our knowledge, there are no prior reports of osteochondromas in such proximity of the talus and calcaneus [4]. Playing on Chromecast. Awareness of such a case is important to consider when evaluating and treating hindfoot arthritis. The cause is usually an acute injury or trauma.
Sprained ankle - Symptoms and causes - Mayo Clinic Ankle impingement is a common condition occurring secondary to sprain or repeated microtrauma. Advertisement. Another condition that is often confused with bone bruise is subperiosteal heamatoma. Inversion Ankle Sprain This probably is the most common ankle injury that occurs to the average person. Axial MRI imaging demonstrates fragmentation within the osteochondroma indicative of two separate, but kissing lesions.
2023 ICD-10-CM Diagnosis Code S90.02XA: Contusion of left ankle Presence of a tumour or growth leads to inflammatory changes in the bone. Weight bearing is not allowed on the injured leg. Similar to the "kissing contusion" patterns seen with ligamentous injuries of the knee, there are analogous bone contusion patterns seen with soft tissue ankle injuries. A direct hit to your muscle or bone can cause a bruising after exercise, which is bleeding underneath the skin due to tissue damage and broken blood vessels. T. he exostoses were removed at their base to the level of native contours of bone at both the talus and calcaneus (Figure 4). In situ compression and fixation was achieved with, two 6.5mm partially threaded screws across the subtalar joint (Figure 5). In this article, injuries common to basketball and, from our experience, injuries that escape injury surveillance systems are discussed from the physician and athletic trainers perspective. An inversion sprain occurs when your ankle twists into an inverted state, or in other words, when it rolls inward.
Kissing contusion type marrow edema at the medial malleolus and medial talar neck with contusion of the anterior to mid deep deltoid fibers. Objective: Type of Sprained Ankle: Understand How Ankles Get Sprained. was consistent with a presumptive diagnosis of osteochondroma.
2023 ICD-10-CM Diagnosis Code S80.02XA: Contusion of left knee, initial you spoke with Raimer?
(PDF) The appearance of kissing contusion in the acutely - ResearchGate A contusion may involve nerve, subcutaneous tissue, tendon, etc. how to recover stolen cryptocurrency from trust wallet; nc state hockey; firehawk aerospace dallas; brenda lowe baby name; observatory hill, pittsburgh crime; buying cigarettes in corfu 0 $ 0.00; 1981 high school basketball player rankings; The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). The mass was identified deep to the FHL with its enveloping bursa (Figure 3). Arthroscopy Copyright 2023 Lineage Medical, Inc. All rights reserved. Single bone contusions are seen more often impacting on one another during an avulsion injury.
Learn how we can help. They comprise 30 to 50% of benign bone lesion diagnoses and 15% of all bone tumors. This cartilage covers most of the talus, with the tibia (shin) and fibula (calf) bones above and to the sides of the talus making up the ankle joint. Figure 6 Histopathology revealed cartilaginous island with an active chondrocyte surrounded by osteoid matrix of the attached bony stalk. Conflict of Interest Declaration The authors declare that there is no conflict of interest regarding the publication of this manuscript. Ankle impingement is a common condition occurring secondary to sprain or repeated microtrauma. We retrospectively reviewed the images of all consecutive patients who underwent MR imaging of the ankle after acute or recurrent sprain occurring between January and December 1997. (, Herrera-Perez M, De Mendoza M, De Bergua-Domingo J, Pais-Brito J. Osteochondromas around the ankle: Report of a case and literature review; International Journal of Surgery Case Reports 4 (2013) 1025 1027. You may be told to keep your foot wrapped with a tight elastic bandage. bipolar kissing lesions advanced osteonecrosis of the talar done Techniques Immobilization and non-weight bearing period of immobilization in cast or boot for 6 weeks, followed by progressive weight bearing with physical therapy emphasizing peroneal strengthening, range of motion, and proprioceptive training outcomes 45% good-excellent outcomes One thing that will certainly be a talking point if LeBrons injury is serious is Solomon Hills role. Approximately 2mm of subchondral bone was removed. Kissing lesions were present in more than half of the lesions in these patients. Foot: Bone marrow oedema in the ankle and the foot can occur in young individuals and give rise to pain in the foot or the ankle without any identifiable cause. Osteochondral Lesions of the Tibial Plafond: A Systematic Review.
Kissing contusion knee | HealthTap Online Doctor 8600 Rockville Pike They represent a dislocation of growth plate cartilage, where normal longitudinal growth occurs adjacent to centripetal growth of the lesion in the metaphyseal region of bone. The coronal image demonstrates the extensive osteoarthritic changes apparent in the subtalar joint of the patient. Cartilage can be focally damaged, producing a "pot hole" in the joint surface, when the knee ligaments are injured. kissing contusion anklevet tech jackets. Two exostoses were noted to be extending posteriorly from the talus and calcaneus, respectively. It does this because it wants it to heal and so all the weight shifts to the ankle.
A to Z: Contusion (Bruise), Ankle (for Parents) - Nemours PMC by Christopher Gaunder MD, Brandon McKinney DO*, Joseph Alderete MD, Thomas Dowd MD, The Foot and Ankle Online Journal 10 (3): 2. When they are slightly deformed or one is too wide, they will rub together causing irritation and the kissing corn will form. Reticular bruises tend to heal the fastest. kissing contusion ankle. You can selectively provide your consent below to allow such third party embeds. The https:// ensures that you are connecting to the Intraoperative photo demonstrating the osteochondroma. A contusion (kun-TOO-zhun), or bruise, of the ankle is an injury to the skin and underlying tissue of the ankle. In 16 (11%) of the 146 ankles, the lesions were present in the opposing bones of the joint ("kissing" lesions). (, Marco RA, Gitelis S, Brebach GT, Healey JH. If you suspect you have a bone bruise, you should see your doctor immediately: left untreated, severe bone bruises can affect your blood flow. The complication that can occur is that the clot may get ossified with bone tissue. Injury to the muscles and tendons of the joints, Joint pain which lasts even when the bruise has healed, Calcaneum bone in the heel. The number and location of subchondral contusions or fractures revealed on MR imaging were recorded, and a comparison was made with the radiographs obtained for each patient. An official website of the United States government. Physical exam reveals some joint swelling but no ligamentous instability. Read More. Given the advanced nature of the lesion and failure of nonoperative modalities, surgical intervention was proposed. 57 KISSING CONTUSIONS CHAPTER 7 Posttraumatic subchondral bone contusions and fractures of the talotibial joint: Occurrence of "kissing" lesions Elizabeth S. Sijbrandij 1, Ad P.G. In children, most toe, foot, or ankle injuries occur during sports, play, or falls.
When Your Athlete Has a Strain, Sprain, or Contusion - Texas Children's LeBron James will be out indefinitely after suffering a high ankle sprain on Saturday as the Los Angeles Lakers took on the Atlanta Hawks. Little Women (2019) Jo March reflects back and forth on her life, telling the beloved story of the March sisters - four young women, each determined to live life on her own terms. if(typeof ez_ad_units != 'undefined'){ez_ad_units.push([[300,250],'hxbenefit_com-banner-1','ezslot_8',149,'0','0'])};__ez_fad_position('div-gpt-ad-hxbenefit_com-banner-1-0');Treatment is primarily rest and elevation of affected leg. Penn orthopaedic surgeons perform the latest minimally invasive techniques to repair loose and torn ligaments due to injury or overuse. Before Contusion of left ankle, initial encounter 2016 2017 2018 2019 2020 2021 2022 2023 Billable/Specific Code S90.02XA is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Symptoms: The main symptoms is pain and swelling of the knee joint which due to the injury of the ligaments and muscles. What is a bone bruise? Bone bruise is defined as the localized blood collection inside a bone which may be associated with an internal fracture in the spongy part of the bone.The cortical layer on the outside remains normal and intact. Should the damage affect the talus in addition to another part of the joint like the tibia or fibula, this can compress or scuff the talus, leading to injury. and transmitted securely. Magnetic resonance imaging demonstrated bony excrescences at the posterior subtalar joint with, disruption of the posterior facet articular surfaces, . FOIA Symptoms are pain and a bluish black skin bruise. In some cases, that loss of blood flow can allow portions of your bone to die, making any damage incurred permanent and irreversible. Posttraumatic subchondral bone contusions and fractures of the talotibial joint: occurrence of kissing lesions. Kissing contusion Contusions of both surfaces of the knee joint are known as kissing contusions. These contusions are generally found by magnetic resonance imaging and most cases are associated with ligamentous or menisceal injuries.[1]. Histopathology revealed cartilaginous island with an active chondrocyte surrounded by osteoid matrix of the attached bony stalk. She was unable to perform High-impact activities and those on uneven ground secondary to pain. The sports like football, basketball, hockey etc have maximum joint movements with speed and so the impact of the injury is greater. Ice packs are useful in reducing the swelling. Osteochondromas of the foot and ankle are uncommon except in rare cases of Multiple Hereditary Exostoses. No funding was acquired for this manuscript. The Achilles tendon was split longitudinally and retracted. Unable to load your collection due to an error, Unable to load your delegates due to an error. The bruise then remains visible until the blood is either absorbed More to Know. (c)Rest of the affected joint or leg is very essential to prevent further damage. (d)Support the affected leg with the help of a splint or walking stick/crutches. She may have had a Trevors lesion of the talus adjacent to more common osteochondroma or periosteal chondroma of the calcaneus. Kissing corns are soft corns that form between your toes, usually the fourth and fifth. People also search for: injury, contusion, sprain, charley horse . Q: Did you ask him if he drank any alcohol?
Sagittal proton density images showing (A) typical kissing contusion Imaging of osteochondroma : variants and complications with radiologic-pathologic correlation. Ankle Injury : Contusion. : Ice the knee for 20 minutes at a time, 3-4 times per day. Medial impingement syndrome of the ankle is common in the athletic population. Memphis Grizzlies forward Brandon Clarke had to be helped off the court on Friday night after he sustained what appeared to be a non-contact left leg injury after shooting a free throw. 2018 Aug;28(6):1199-1207. doi: 10.1007/s00590-018-2161-7. Unauthorized use of these marks is strictly prohibited. Figure 1 Location of the OCL according to the mechanism of trauma. She is the daughter of mob boss, Julian Jerome and his ex-wife, attorney, Alexis Davis via one night stand. Joint Diseases and Related Surgery. contusion: [ kon-toozhun ] injury to tissues with skin discoloration and without breakage of skin; called also bruise . Trae Young last year suffered a grade 2 lateral left ankle sprain during the regular season. 6. MeSH terms Adolescent Adult Anterior Cruciate Ligament Injuries Arthroscopy / methods Athletic Injuries / diagnosis*
Osteochondral Lesions of the Talus - Foot & Ankle - Orthobullets (, O. ahap Atik, M.D., Baran Sarkaya, M.D., Cemalettin Kunat, M.D., Ramin Muradi, M.D., Bahadr Ocaktan, M.D., Hseyin Topu, M.D. - James Stone, MD, Foot & AnkleOsteochondral Lesions of the Talus, Asymptomatic Medial Talar Dome OCD in a 17M, Osteochondral Lesions of the Talus with Midfoot Arthritis, Talus fracture, OCD, cartilage fragment, subchondral cyst. Impaction and geographic bruises take moderate amount of time. Note the similar appearance to a normal physis seen in children.
Essential Considerations In Treating Osteochondral Lesions Of The Talus Its important to note that, with a blunt injury, you may have bruised some bones and fractured others, so X-rays are a good way to determine the full extent of your injury. Arthroscopic drilling for chondral, subchondral, and combined chondral-subchondral lesions of the talar dome. The injury occurs when one or more of the ligaments in the ankle are stretched or torn, causing pain, swelling, and difficulty walking.