Mosaicplasty by a Modified Lateral Malleolus Osteotomy Approach for Osteochondral Lesion of Talus

Background : Osteochondral lesions of talus commonly affect the medial and anterolateral dome. These acquired or idiopathic lesions of the articular cartilage are least likely to affect the posterolateral part of the dome. Furthermore, if encountered, they are difficult to manage due to the limited surgical exposure. Case Report : We report a case of idiopathic osteochondral lesion of the lateral talar dome in a 40-year-old male. He presented with recurrent ankle effusion and pain, disabling his activities of daily living. He was managed by osteochondral autologous grafting by a modified lateral malleolus osteotomy approach. Osteotomy site was fixed with 1/3 rd tubular plate. Patient improved clinically. Conclusion : To overcome the complications associated with the traditional lateral transmalleolar approach we made certain modifications like keeping the anterior talofibular ligament and calcaneofibular ligament intact. We believe this helps in minimizing lateral instability and could encourage more surgeons to take up this approach.