Chopart Dislocation

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Definition

 

Chopart joints

- talonavicular joint

- calcaneocuboid joint

 

Injury patterns

 

TNJ +/- CCJ

 

Ligamentous +/- fracture dislocations

 

Fractures - trans-navicular / trans-cuboid

 

Richter et al Foot Ankle 2004

- 110 Chopart joint dislocations

- 25% pure ligamentous dislocations

- 55% fracture-dislocations

- 20% combined Chopart-Lisfranc injuries

 

Etiology

 

High energy injury

- MVA

- fall from height

 

Richter et al Foot Ankle 2004

- 110 Chopart joint dislocations

- 25% compartment syndrome

 

Imaging

 

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Chopartchopart

 

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Management

 

Urgent closed +/- reduction reduction

 

Anatomic reduction and stabilization

- dorsomedial - talonavicular joint

- dorsolateral approach - calcaneocuboid joint

 

Pure ligamenous dislocation fixation

- percutaneous K wires

- bridging plates

 

Fracture-dislocation fixation

- plate fixation of navicular / cuboid fractures

- bridging plates

- +/- bridging external fixation intra-operative / postoperative

- +/- primary arthrodesis in severe comminution

 

Observe for compartment syndrome

 

AO foundation management Chopart injuries

 

Vumedi Chopart surgery video

 

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Results

 

Richter et al Foot Ankle 2004

- 110 Chopart joint dislocations

- better outcomes with ligamentous dislocations versus fracture dislocations

 

Rammelt et al J Orthop Trauma 2023

- 128 Chopart joint injuries with 10 year follow up

- better results with ORIF versus closed reduction / percutaneous fixation

- 93% OA but only 4% required late fusion