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Chopart injuries

Stefan Rammelt, Tim Schepers
Chopart joint injuries have a profound effect on global foot function. Surgical treatment aims at joint reconstruction and axial alignment with restoration of the normal relationship of the lateral and medial foot columns. Internal fixation is tailored to the individual fracture pattern and achieved with resorbable pins, Kirschner wires, screws, and/or anatomically shaped minifragment plates. If instability persists, temporary joint transfixation may be achieved with Kirschner wires or bridge plating. Primary fusion sacrifices essential joints and should be reserved for severe initial cartilage damage...
March 2017: Foot and Ankle Clinics
Andrew P Harris, Joseph A Gil, Avi D Goodman, Christopher R Nacca, Todd R Borenstein
The midtarsal joint, also known as the Chopart or the transverse tarsal joint, is composed of the talonavicular and calcaneocuboid articulations.(1) Midtarsal joint dislocations are rare injuries given the strong periarticular ligamentous support.2, 3 Medial, lateral, dorsal, and rarely plantar dislocations have been reported from multiple high-energy mechanisms.4, 5 We describe the case of a 24-year-old male who sustained talonavicular and calcaneocuboid plantar dislocations associated with a middle and lateral intercuneiform dislocation, open proximal 5th metatarsal fracture, 2nd-4th metatarsal base fractures, and lateral cuneiform fracture...
March 2017: Journal of Orthopaedics
A Thiounn, C Szymanski, C Lalanne, K Soudy, X Demondion, C Maynou
INTRODUCTION: Foot and ankle injuries (FAI) are very common, with about 6000 cases per day in France. Unlike lateral ankle sprain (LAS), the diagnosis of midtarsal joint sprain (MJS, also known as Chopart's joint sprain) is not widely known. This prospective study aims to detail the epidemiology of MJS and compare it to LAS. PATIENTS AND METHOD: The study was conducted within our institution over a period of 16 months. Patients with clinical signs predictive of MJS without radiographic bone lesion underwent ultrasound assessment...
September 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
Wolfgang Schneiders, Stefan Rammelt
Treatment of malunion and nonunion at the Chopart joint aims at axial realignment of the midfoot to the hindfoot and restoration of the normal relationship of the lateral and medial columns of the foot. In carefully selected patients with intact cartilage, joint-preserving osteotomies are feasible at all 4 bony components of the Chopart joint to restore near-normal function. Priority should be given to the anatomic reconstruction of the talonavicular joint because it is essential for global foot function. Patients must be counseled about the risk of progressive arthritis or osteonecrosis necessitating late fusion...
March 2016: Foot and Ankle Clinics
Mari Shimizu, Hajime Matsumine, Masaki Takeuchi
A 63-year-old man dropped a metal chunk onto his left foot during his work and suffered a crush injury of the left forefoot. He underwent Chopart's amputation followed by stump coverage with sole skin at the orthopedic department on the same day. He was referred to our department for reconstruction because of poor vascularization and subsequent necrosis of tissue at the stump. After the necrotic tissue was debrided, exposure of the talus bone was noted. An artificial dermis was then applied to the stump wound, followed by local negative pressure wound therapy...
November 2015: Plastic and Reconstructive Surgery. Global Open
S Rammelt, H Zwipp
BACKGROUND: Injuries to the mid-tarsal (Chopart) joint are frequently overlooked or misinterpreted and therefore, not adequately treated at initial presentation. Malunion results in a loss of essential joint function and a three-dimensional malalignment leading to considerable impairment of global foot function and a rapid development of painful posttraumatic arthritis. METHODS: If no symptomatic arthritis is present, joint displacement or non-union may be subject to secondary anatomical reconstruction and internal fixation...
September 2014: Der Unfallchirurg
C Kösters, S Bockholt, C Müller, C Winter, D Rosenbaum, M J Raschke, S Ochman
OBJECTIVES: Complex midfoot injuries could lead to severe functional impairment of mobility and quality of daily living. Aim of this study was to compare the clinical and functional outcomes of Chopart, Lisfranc fractures and multiple metatarsal shaft fractures. DESIGN: Retrospective case series. SETTING: Level one trauma center. INTERVENTION: Open or closed reduction and internal fixation with screws, K-wires, plates, external fixation or combination of different technics...
October 2014: Archives of Orthopaedic and Trauma Surgery
Bas Govaert, Gert P Kuijt, Percy V van Eerten
BACKGROUND: Injuries to the Chopart joint of the tarsal foot are relatively rare, difficult to recognize and are associated with significant long term morbidity. CASE DESCRIPTION: A 16-year-old boy attended the emergency department after a forklift truck ran over his left foot. Physical examination and X-ray evaluation revealed a fracture of the Chopart joint with a navicular bone fracture and dislocation of the calcaneo-cuboidal joint. Operative open reduction and internal fixation was performed...
2014: Nederlands Tijdschrift Voor Geneeskunde
Sang Wha Kim, Seung Bae Jeon, Kyu Tae Hwang, Youn Hwan Kim
Amputation of the extremities is a definitive reconstructive option, and surgeons should aim to preserve maximum overall function. If the exposed bone cannot be adequately covered using local tissues, the stump can be reconstructed using a number of well-described free flap transfer techniques. Between January 2002 and December 2011, 31 patients with severe injuries to the lower extremities underwent above-the-knee, below-the-knee, and Chopart and Ray amputations. Bony stumps were covered using latissimus dorsi myocutaneous flaps alone (group 1), or together with serratus anterior muscle flaps (group 2)...
January 2016: Annals of Plastic Surgery
Marco Cianforlini, Mario Marinelli, Isabella Ponzio, Luigi de Palma
We present a 49-year-old man with a traumatic subamputation of the forefoot, associated with lacerated wound in correspondence of the dorsal surface of the right foot, with injuries of tendinous, ligamentous and vascular structures and with the loss of talus head. The patient underwent salvage arthrodesis of the talonavicular and calcanealcuboid joints with graft bone harvested from the iliac crest. The patient was re-evaluated during a clinical and radiographic follow-up. The arthrodesis was consolidated in ∼3 months...
February 2014: Journal of Surgical Case Reports
Norbert Harrasser, Guntmar Gradl
No abstract text is available yet for this article.
April 30, 2014: MMW Fortschritte der Medizin
Hui Zhang, Li Min, Guanglin Wang, Lei Liu, Yue Fang, Chongqi Tu
OBJECTIVE: To evaluate the clinical and radiographic outcomes of headless compression screws for Lisfranc joint injuries. METHODS: A retrospective analysis was made on clinical data of 34 patients (36 feet) with Lisfranc joint injuries who underwent open reduction and internal fixation with headless compression screws between January 2006 and January 2012. There were 22 males (24 feet) and 12 females (12 feet), aged 21-73 years (mean, 38.9 years). The causes of injury included traffic accident in 16 cases (17 feet), falling from height in 11 cases (12 feet), crushing in 5 cases (5 feet), and sports in 2 cases (2 feet)...
October 2013: Chinese Journal of Reparative and Reconstructive Surgery
S Ochman, J Evers, M J Raschke
OBJECTIVE: Anatomical repositioning of isolated fractures of the anterior process of the calcaneus. Internal fixation for sufficiently large fragment sizes, for small fragments and evidence of instability of the calcaneocuboid (CC) joint in association with Chopart luxation fractures, transfixation of the CC joint. INDICATIONS: Dislocated fragments and intra-articular fractures (contraindication to open repositing: critical soft tissue relationships) and temporary stabilization for Chopart luxation fractures...
December 2013: Operative Orthopädie und Traumatologie
Sermet Inal, Canan Inal
In published studies, a very rare, special type of Chopart dislocation termed a swivel dislocation has been reported. This injury is characterized by dislocation of the talonavicular joint, but the calcaneocuboid joint remains intact. The foot creates a typical rotational movement without inversion or eversion. The axis of rotation is the interosseous talocalcaneal ligament, which remains intact. We report the case of an 18-year-old male who had experienced a medial swivel dislocation of the talonavicular joint associated with displaced fractures of the fourth and fifth metatarsals...
July 2013: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Rammelt, Grass, Zwipp
Nutcracker fractures of the tarsal navicular and cuboid usually result from dislocations of the mid-tarsal (Chopart's) joint. The classic pathomechanism consists of forced adduction or abduction (medial or lateral stress) mostly in combination with axial force. The resulting injuries are frequently misjudged or underestimated with respect to their potential consequences for global foot function. Radiographic imaging includes plain radiographs in exact standard projections and computed tomographic scanning. Classification of Chopart fracture-dislocations is based on the proposed pathomechanics and the direction of the dislocating force...
July 1, 2004: Therapeutische Umschau. Revue Thérapeutique
Stephen K Benirschke, Eric G Meinberg, Sarah A Anderson, Clifford B Jones, Peter A Cole
The midfoot is a complex association of five bones and many articulations between the forefoot metatarsals and the talus and calcaneus, which make up the hindfoot. These anatomic relationships are connected and restrained by an even more complex network of ligaments, capsules, and fascia, which must function as a unit to provide normal and painless locomotion. The common eponyms of Lisfranc and Chopart refer to the distal and proximal joint relationships of the midfoot, respectively. Midfoot injuries range from single ligament strains to complicated fracture-dislocations involving multiple bones and joints...
2013: Instructional Course Lectures
Stephen K Benirschke, Eric Meinberg, Sarah A Anderson, Clifford B Jones, Peter A Cole
No abstract text is available yet for this article.
July 18, 2012: Journal of Bone and Joint Surgery. American Volume
T Mittlmeier, M Beck
Injuries of the midfoot comprise fractures, dislocations and/or fracture dislocations of the Chopart and Lisfranc joint lines. Fracture dislocations, in particular, represent prognostically severe lesions which may compromise foot function to a substantial degree. A number of injuries of the midfoot (up to one quarter) are still primarily overlooked. As such, a diagnostic algorithm is essential for the adequate detection of the injury components and planning of the therapeutic approach. Standard x-rays in three planes (dorso-plantar, lateral and lateral oblique views) represent the diagnostic basis which is supplemented by CAT scanning and multiplanar reconstruction, especially in cases where a potential midfoot lesion is suspected...
February 2011: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Steven F Boc, Sharmila Das-Wattley, Eric Roberts
Synovial sarcomas occur primarily in the soft tissue structures adjacent to the joints and tendons of the extremities. A diagnostic dilemma exists when the clinical presentation is similar to that of an infection or soft tissue trauma. We report a case of soft tissue sarcoma of the foot in a previously healthy 19-year-old male who presented after hitting his right foot against a refrigerator. Initial radiographs were negative; however, 6 weeks later plain radiographs revealed destruction of the metatarsals...
January 2011: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Karin B van Dorp, Mark R de Vries, Maarten van der Elst, Tim Schepers
Injuries involving the Chopart joint complex are relatively rare and frequently missed or misdiagnosed, often leading to a poor functional outcome. This study was performed to determine the outcome and morbidity in patients with Chopart joint injuries, and to increase awareness of this severe injury. Patients with a Chopart dislocation or fracture-dislocation, treated between January 2004 and January 2010, were identified using the appropriate diagnosis code and reviewing all radiographs of patients diagnosed with hindfoot or midfoot injuries treated at our institution...
November 2010: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
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