case_images: PMC11795242_01
case_images: Preoperative CT scan (A: coronal, B: sagittal and C: axial). A medial osteochondral lesions of the talus is present, crater-like. The dimensions are 15 mm anteroposterior, 7 mm mediolateral and 8 mm in depth.
case_images: bcr-18-1-g001.jpg
case_images: PMC11795242_01_bcr-18-1-g001.jpg
case_images: F1
case_images: A CT scan revealed a medial OLT in zone 4 (figure 1).
case_images: PMC11795242_02
case_images: Intraoperative confirmation of the screw placement on anteroposterior (A) and lateral (B) views. The screws and osteotomy are in adequate position and compression over the osteotomy is confirmed.
case_images: bcr-18-1-g002.jpg
case_images: PMC11795242_02_bcr-18-1-g002.jpg
case_images: F2
case_images: No intraoperative complications occurred, and the osteotomy was fixated with two 3.5 mm cortical screws and sufficient compression and adequate position was confirmed using fluoroscopy intraoperatively (figure 2).
case_images: PMC11795242_03
case_images: CT scan (A: coronal, B: sagittal and C: axial) 10 weeks postoperatively after 5 weeks in a non-weight-bearing cast and 5 weeks in a walking cast. Complete radiological union of the osteotomy is conformed and graft ingrowth on the site of the (excised) osteochondral lesions of the talus is seen.
case_images: bcr-18-1-g003.jpg
case_images: PMC11795242_03_bcr-18-1-g003.jpg
case_images: F3
case_images: 10 weeks postoperatively, a CT scan confirmed osteotomy union and graft incorporation (figure 3).
case_images: PMC11795242_04
case_images: Picture taken at the outpatient clinic, showing evident swelling over the medial malleolus.
case_images: bcr-18-1-g004.jpg
case_images: PMC11795242_04_bcr-18-1-g004.jpg
case_images: F4
case_images: Six weeks after removal of the walking cast (16 weeks postoperatively), the patient presented at the outpatient clinic with sudden swelling and pain in his ankle (figure 4).
case_images: CT scan (A: coronal, B: sagittal and C: axial) after sudden swelling. A fracture line in the medial malleolus is seen, through the previous osteotomy line.
case_images: bcr-18-1-g005.jpg
case_images: PMC11795242_04_bcr-18-1-g005.jpg
case_images: F5
case_images: The CT scan showed a non-displaced acute on chronic stress fracture of the anterior part of the osteotomy between the two screws (figure 5).