(Some of you stumbled a bit during the "Residency Rumble" when a
question on this topic was asked.)
A thorough understanding of the mechanisms of acute and chronic
cartilage injuries is required prior to treating patients with this type
of trauma. In preparation of their Board Exams, many practitioners have
relied on the mnemonic
"Dial a Pimp"
Simply stated, this means:
Dorsiflexion
Inversion injuries result in
an Anterior
Lateral lesions
Plantar flexion
Inversion injuries
results in a Medial
Posterior lesions
A center lesion at the talar dome can result from strong
axial loading.
CT and MRI's are helpful in making the diagnosis. Initial
treatment may involve a short leg cast. The goal here is to eliminate
symptomatology, not necessarily to heal the lesion. Interestingly, it may take
up to 71/2 months to see radiographic evidence of healing.
Dr. Dolce feels that surgical treatment is mandated for Stage
III lateral lesions as well as Stage IV lesions. He reviews the
instrumentation, the portals and the "concept of triangulation".
Ankle Arthroscopy is ideal for the treatment of
Thank you Dr. Dolce and in fact, the entire Ohio College, for
being so supportive of PRESENT Courseware.
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