Chopart Injuries: When to Fix and When to Fuse?
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. Corrective fusion becomes necessary for malunited Chopart joint injuries with rapidly evolving posttraumatic arthritis.
Foot & Ankle Section, University Center for Orthopaedics and Traumatology, University Hospital Carl-Gustav Carus, Fetscherstrasse 74, Dresden 01307, Germany. Electronic address: strammelt@hotmail.com.
Stefan
S
Rammelt
Trauma Unit, Academic Medical Center, Meibergdreef 9, PO Box 22660, Amsterdam 1100 DD, The Netherlands.
Tim
T
Schepers
D001174:Arthrodesis; D018409:Foot Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D000072039:Fracture Dislocation / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D057072:Intra-Articular Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D013640:Tarsal Joints / Q000293:injuries / Q000601:surgery*
Anterior calcaneal process; Corrective fusion; Cuboid; Fracture; Internal fixation; Midtarsal joint; Navicular; Talar head