A talar dome lesion involves damage to the cartilage and bone beneath the talus inside the ankle joint. It is important to note that the ankle joint is comprised of the tibia in the bottom and the talus on top. The upper region of the talus has a dome shape and covered completely by cartilage that enables the joint to move smoothly.
This lesion is generally brought about by an injury such as an ankle sprain. In case the cartilage does not properly heal after an injury, it becomes soft and starts to break off. Oftentimes, a broken fragment of the damaged cartilage and bone “floats” in the ankle.
What are the indications?
Unless the injury is significant, it might take months, a year or even longer for the symptoms to arise. The usual indications of a talar dome lesion include:
- Chronic pain or discomfort deep within the ankle that worsens if bearing weight on the foot and reduced while resting
- Occasional “catching” or “clicking” sensation in the ankle while walking
- Episodes of swelling in the ankle that occurs during weight bearing and settles while at rest
- Sensation that the ankle is “locking” or about to “give out”
Management of a talar dome lesion
The treatment for a talar dome lesion is based on the severity. In case the lesion is stable, one or several of the following conservative measures might be considered:
- Immobilization – the leg might be placed in a cast or cast boot to protect the talus. During this phase, non-weightbearing exercises for the range of motion might be suggested.
- Oral drugs – non-steroidal anti-inflammatory drugs (NSAIDs) can help in minimizing the pain and inflammation
- Ankle brace – a brace can also help in protecting the individual from re-injury if it is unstable
- Physical therapy – strengthening and range-of-motion exercises are useful once the lesion has adequately healed. Physical therapy might also include techniques to lower the swelling and pain
Is surgery required?
In case the conservative measures fail to effectively alleviate the symptoms of talar dome lesion, surgery might be required.
Surgical intervention might involve the removal of loose bone and cartilage fragments inside the joint to establish an environment suitable for healing.
Quick Note / Disclaimer
The material posted on this page on talar dome lesion is for learning and educational purposes only. To learn to recognize and manage this injury, register for a first aid and CPR course with Victoria First Aid.