[Correction of heel strike in a hindfoot stump not adequate for weightbearing following Chopart amputation. Tibiocalcaneal arthrodesis and intramedullary nailing].
Chopart amputation leaves a very efficient hindfoot stump allowing full plantigrade weightbearing, even without an artificial limb in place for short distances. It must be said that this presupposes that the sole is covered with skin originally taken from the sole of the foot and that the tread of the heel is correct. Imbalance of the tendons frequently causes an increasing equinovarus deformity, which can lead to secondary problems. We report on a 28-year-old man with a stump in a fixed equinovarus deformity following traumatic Chopart amputation. Weightbearing was not possible, and constant ulcers entailed frequent periods of unfitness for work, so that he expressly requested below-knee amputation at first. Correction of the equinovarus deformity by tibiocalcaneal arthrodesis using intramedullary nailing led to lasting healing of the skin and the possibility of full weightbearing.
Lehrstuhl für Orthopädie der F.-Schiller-Universität Jena, Am Waldkrankenhaus R. Elle Eisenberg gGmbH, Klosterlausnitzer Str. 81, 07607, Eisenberg. xandreaswagnerx@aol.com
A
A
Wagner
R
R
Fuhrmann
D000328:Adult; D000671:Amputation, Surgical / Q000009:adverse effects*; D000672:Amputation Stumps; D000843:Ankle Joint / Q000601:surgery*; D001174:Arthrodesis / Q000295:instrumentation / Q000379:methods*; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation / Q000379:methods*; D020233:Gait Disorders, Neurologic / Q000209:etiology* / Q000601:surgery*; D006801:Humans; D008297:Male; D016896:Treatment Outcome; D016474:Weight-Bearing