Chopart's fracture-dislocation

Chopart's Fracture-Dislocation

Chopart's fracture-dislocation is a type of injury that involves the Chopart joint, which is located in the midfoot. This injury is characterized by a fracture and dislocation of the bones that form the Chopart joint, specifically the talonavicular joint and the calcaneocuboid joint.

Anatomy

The Chopart joint, also known as the transverse tarsal joint, is composed of two main joints:

• The talonavicular joint, which is formed between the talus and the navicular bone.
• The calcaneocuboid joint, which is formed between the calcaneus and the cuboid bone.

These joints allow for complex movements of the foot, including inversion and eversion, which are crucial for walking and balance.

Mechanism of Injury

Chopart's fracture-dislocation typically occurs due to high-energy trauma, such as a fall from a height, a motor vehicle accident, or a sports-related injury. The mechanism often involves a forceful twisting motion of the foot, leading to dislocation and associated fractures.

Clinical Presentation

Patients with Chopart's fracture-dislocation usually present with:

• Severe pain in the midfoot region.
• Swelling and bruising around the affected area.
• Inability to bear weight on the affected foot.
• Visible deformity in severe cases.

Diagnosis

Diagnosis of Chopart's fracture-dislocation is primarily made through:

• Physical examination: Assessing for tenderness, swelling, and deformity.
• Imaging studies:

 * X-ray: Initial imaging to identify fractures and dislocations.
 * CT scan: Provides detailed images of the bone structures and is useful for surgical planning.
 * MRI: May be used to assess soft tissue injuries.

Treatment

The treatment of Chopart's fracture-dislocation depends on the severity of the injury:

• Non-surgical treatment: In cases where the dislocation is minor and the fractures are stable, conservative management with immobilization in a cast or boot may be sufficient.
• Surgical treatment: Severe cases with significant dislocation or unstable fractures often require surgical intervention to realign the bones and stabilize the joint. This may involve:

 * Open reduction and internal fixation (ORIF).
 * Temporary external fixation in cases of severe soft tissue swelling.

Rehabilitation

Rehabilitation is crucial for recovery and involves:

• Physical therapy to restore range of motion and strength.
• Gradual weight-bearing as tolerated.
• Long-term follow-up to monitor for complications such as post-traumatic arthritis.

Prognosis

The prognosis for Chopart's fracture-dislocation varies depending on the severity of the injury and the success of the treatment. Early diagnosis and appropriate management are key to achieving a good functional outcome.

Also see

• Lisfranc injury
• Talus fracture
• Calcaneal fracture
• Foot anatomy