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Experience with forty-nine patients with surgically treated transchondral fractures of the talar dome seen between 1957 and 1977 at our institution has indicated that surgical treatment yields a good long-term result. Long-term results in twenty-five patients with sufficiently long follow-up (average, sixty-five months) were recorded. Ninety-two per cent of the patients had had a history of severe ankle sprain or fracture and many had had chronic symptoms before the definitive diagnosis was made. The surgical treatment consisted of drilling and curettage followed by non-weight-bearing and early range-of-motion exercises. Twenty-two patients had good or excellent results, two had fair results, and one had a poor result. In eleven patients followed for five to eighteen years, no deterioration in functional capacity was noted; however, improvement in the postoperative status was noted for as long as eighteen months. Even when it was performed for a chronic lesion the operation gave a high percentage of good results, and the long-term results did not differ appreciably from the results eighteen months postoperatively. No other reports were found concerning long-term follow-up of this lesion.