# Incidence and Location of Osteochondral Lesions of the Talus Associated With Ankle Fractures Evaluated by Magnetic Resonance Imaging

## TL;DR

This study finds that over a quarter of ankle fractures are associated with osteochondral lesions of the talus, most commonly in the posterolateral region, and these lesions are more frequent in isolated malleolar fractures.

## Contribution

The study provides new insights into the incidence and location of OLTs in ankle fractures using acute MRI data.

## Key findings

- OLTs were found in 26.9% of ankle fracture patients using acute MRI.
- The posterolateral talus was the most common location for OLTs.
- OLTs were more frequent in isolated malleolar fractures compared to bimalleolar or trimalleolar fractures.

## Abstract

Objective: Osteochondral lesions of the talus (OLTs) are known to be one of the causes of residual pain after ankle fractures. Few reports investigate the incidence and location of OLTs associated with ankle fractures using magnetic resonance imaging (MRI) at the time of injury. The purpose of this study is to determine the incidence and anatomical distribution of OLTs on acute MRI in patients with ankle fractures using MRI at the time of injury.

Methods: Consecutive 84 patients with ankle fractures who underwent MRI within one week of injury between October 2021 and May 2023 were included in this study. The diagnosis of an ankle fracture and evaluation of the fracture type were performed with plain radiographs and computed tomography, and an MRI was performed to assess the incidence and location of OLTs. In addition, the incidence of isolated fractures was compared with that of bimalleolar and trimalleolar fractures. After exclusion, the remaining 67 patients were analyzed.

Results: OLTs were found in 18 of 67 patients (26.9%). All lesions were isolated talar lesions; the posterolateral aspect of the talus occurred most frequently in 7 of 18 patients (38.9%). In addition, OLTs occurred in 12 of 29 patients (41.4%) with isolated malleolar fractures, which was significantly higher than the combined incidence of bimalleolar and trimalleolar cases (6/38: 15.8%) (P=0.027).

Conclusion: Acute MRI detects OLTs in over one quarter of ankle fractures, most commonly in the posterolateral talus. Additionally, the incidence of OLTs was significantly higher in patients with isolated malleolar fractures.