PMC6157136_01
X-ray of the hind foot, lateral view, showing a 1.8 cm accessory posterior bone fragment (arrow).
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Initial plain radiographs showed a considerable (1.8 cm) posterior bone fragment in relation with the talus (Figure 1).
Comparative CT scan showing posterior bone process, displacing into the medial side (arrow) in both coronal (a) and axial (b) view.
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At this point, talus bipartitus (TB) diagnosis was suspected (Figure 2).
MRI, sagittal view of the ankle; the presence of cartilage between the talar body and the accessory bone can be appreciated (stars).
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MRI disclosed the presence of an inflammatory process, bone fragment covered with cartilage, and what appears to be a degenerative synchondrosis as a consequence of posteromedial impingement (Figure 3).
Medial approach with exposure of the pseudoarticular space (star), tibialis posterior retracted forward (yellow arrow), and the accessory bone fragment (white arrow).
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The bone fragment was removed and the tunnel was released (Figure 4).
Comparative preoperative (a) and postoperative X-rays with no residual bone (b).
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Postoperative radiographs showed the complete absence of residual bone fragment (Figure 5).