Vascularized Bone Autograft for the Treatment of Chondroblastoma of the Talus at Imminent Risk of Joint Breakdown: Three Case Reports

• Published in: The Journal of foot and ankle surgery Vol. 58; no. 2; pp. 363 - 367
• Main Authors: Wagener, Joe, Schweizer, Christine, Horn Lang, Tamara, Zwicky, Lukas, Schaefer, Dirk Johannes, Hintermann, Beat
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.03.2019
• Subjects: ankle; benign bone tumor; iliac crest; medial femoral condyle; talar defect; talar defect; medial femoral condyle; 4; benign bone tumor; ankle; iliac crest
• ISSN: 1067-2516; 1542-2224
• DOI: 10.1053/j.jfas.2018.08.053

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.