The talar dome (trochlea tali) is the superior articular surface of the talus that fits within the ankle mortise formed by the distal tibial plafond above and the medial and lateral malleoli on either side. Its wider anterior dimension compared to the posterior ensures the ankle is most stable in dorsiflexion (wider dome locked in the mortise). Osteochondral lesions of the talar dome are among the most common complications of ankle sprains.
Osteochondral lesions of the talus (OLT) typically occur on the posteromedial or anterolateral talar dome from inversion ankle sprain mechanisms. They produce chronic ankle pain, swelling, and catching sensations. Classification by MRI (Berndt and Harty) guides treatment — unstable lesions with fluid undercutting on MRI require surgical treatment (arthroscopic debridement and microfracture for small lesions, osteochondral autograft or allograft for large defects).
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