Intraosseous pseudotumour of the talus in a child with severe haemophilia.

Abstract

We report a case of a large pseudotumour in the right talus of an 11-year-old boy with severe haemophilia A. The described intraosseous lesion was treated with surgical curettage and autologous bone grafting. Twenty months postoperatively computed tomography scan showed no signs of recurrence. Forty months postoperatively radiological studies confirmed satisfactory incorporation of the graft, no evidence of bone growth disturbance and improvement of Pettersson score of the ankle joint. At the same time, regarding his clinical situation, he was able to fully participate in his daily activities, presenting painless and almost full range of motion of his right ankle joint. Surgical intervention seems to be the best option in treating a big pseudotumour of the talus during childhood. As conservative management in the treatment of large lesions may fail, disastrous complications like a pathological fracture may happen. Anatomical reconstruction of a talus when pseudotumour and pathological fracture coexist is a major challenge for an orthopaedic surgeon.