Chopart Joint Fracture-Dislocation: Initial Open Reduction Provides Better Outcome than Closed Reduction

Richter, Martinus; Thermann, Hajo; Huefner, Tobias; Schmidt, Ulf; Goesling, Thomas; Krettek, Christian

doi:10.1177/107110070402500512

Cited by 87 publications

(77 citation statements)

References 18 publications

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“…Early anatomic reduction, stable fixation, and ligament reconstruction could have achieved a better outcome. [9][10][11] Closed reduction yields good results only in cases of pure dislocation …”

Section: Discussionmentioning

confidence: 99%

Salvage Arthrodesis for Fracture-Dislocation of the Cuneonavicular and Calcaneocuboid Joints: A Case Report

Kang

Rikhraj

2008

J Orthop Surg (Hong Kong)

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We present a 22-year-old man with dislocation of both the calcaneocuboid and cuneonavicular joints and fractures of the calcaneum and navicular of the right foot. The joints were reduced with percutaneous Kirschner wires, but the disrupted dorsal cuneonavicular ligaments were left unrepaired. Reduction was suboptimal and the joints were subluxed resulting in disabling arthralgia. Six months later, he underwent salvage arthrodesis of the subluxed calcaneocuboid and cuneonavicular joints. At 24-month follow-up, the patient had returned to work and remained pain-free when walking, with good fusion of both joints. Early anatomic reduction, stable fixation, and ligament reconstruction are essential for a good outcome. Arthrodesis is indicated when subluxation and posttraumatic arthritis are present. Primary arthrodesis is a viable option for severe midfoot fracture-dislocations, because it facilitates rehabilitation and functional recovery, and Salvage arthrodesis for fracture-dislocation of the cuneonavicular and calcaneocuboid joints: a case report GC Kang, IS RikhrajDepartment of Orthopaedic Surgery, Singapore General Hospital, Singapore Address correspondence and reprint requests to: Dr Inderjeet Singh Rikhraj, Department of Orthopaedic Surgery, Singapore General Hospital, Outram Road, 169608, Singapore. E-mail: inderjeet.rikhraj@sgh.com.sg Surgery 2008;16(3):396-9 obviates the need for a secondary arthrodesis should arthritis arise. Journal of Orthopaedic

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Section: Discussionmentioning

confidence: 99%

Salvage Arthrodesis for Fracture-Dislocation of the Cuneonavicular and Calcaneocuboid Joints: A Case Report

Kang

Rikhraj

2008

J Orthop Surg (Hong Kong)

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“…Early anatomical reduction and stable fixation has been shown to improve the clinical results in other types of midfoot dislocation. 7,8 In the present case, a closed anatomical reduction was achieved using percutaneous screws to minimise surgical trauma to the soft tissue. The screws were kept in place for a longer period (14 weeks) than that suggested by Richter et al (6-10 weeks), 7,8 because considerably more soft tissue was involved.…”

Section: Discussionmentioning

confidence: 99%

“…7,8 In the present case, a closed anatomical reduction was achieved using percutaneous screws to minimise surgical trauma to the soft tissue. The screws were kept in place for a longer period (14 weeks) than that suggested by Richter et al (6-10 weeks), 7,8 because considerably more soft tissue was involved. Nonetheless, residual insufficiency of plantar ligamentous structures occurred, resulting in plantar opening up of the joint space.…”

Section: Discussionmentioning

confidence: 99%

Isolated Dorsal Midtarsal (Chopart) Dislocation: A Case Report

Ip¹,

Lui²

2006

J Orthop Surg (Hong Kong)

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A case of isolated dorsal midtarsal (Chopart) dislocation resulting from blunt trauma is reported. The mechanism of injury, management, and longterm outcome are discussed. A 45-year-old inebriated man fell from a 4-m height and landed on his feet. He had immediate bilateral foot and back pain. Radiographs showed a burst fracture of the second lumbar vertebra, a left Pott's fracture, and an isolated dorsal dislocation of the right midtarsal (Chopart) joint. No neurovascular deficits or signs of compartment syndrome were noted. The image intensifier showed the unstable midtarsal joint with dorsal translation of the navicular and cuboid from the talus and calcaneum, respectively. Closed reduction of the midtarsal joint was performed with 2 transfixing 3.5-mm AO cortical screws. The right foot was immobilised in a short leg cast for 6 weeks; screws were removed 14 weeks later. At 76-month follow-up, the patient had returned to work as a construction worker, but still had right midfoot pain on prolonged walking or standing, because of persistent plantar opening up and dorsal ossification of the midtarsal joints and degenerative change at the talonavicular

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“…Patients managed without surgery had significantly poorer outcomes that those managed with any surgical technique. 83 As with other midfoot injuries, Lisfranc (tarsometatarsal) injuries can produce significant problems if left untreated. Reduction of the joints often requires a dual-incision approach with the medial incision centered over the first Web space, and extended proximally, while the lateral incision is centered over the proximal half of the fourth metatarsal shaft.…”

Section: Foot Fracturesmentioning

confidence: 99%

Management of High-Energy Foot and Ankle Injuries in the Geriatric Population

Herscovici

Scaduto

2012

Geriatr Orthop Surg Rehabil

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By the year 2035 almost 20% of the US population of 389 million people will be 65 years and older. What this group has, compared with aged populations in the past, is better health, more mobility, and more active lifestyles. From January 1989 through December 2010, a total of 494 elderly patients with 536 foot and ankle injuries were identified. Within this group, 237 (48%) patients with 294 injuries were sustained as a result of a high-energy mechanism. These mechanisms consisted of 170 motor vehicle accidents, 30 as a result of high (not ground level) energy falls, 2 from industrial accidents, and 35 classified as other, which included sports, blunt trauma, bicycle, airplane or boating accidents, crush injuries, and injuries resulting from a lawn mower. The injuries produced were 17 metatarsal fractures, 9 Lisfranc injuries, 10 midfoot (navicular, cuneiform, or cuboid) fractures, 23 talus fractures, 63 calcaneal fractures, 73 unimalleolar, bimalleolar, or trimalleolar ankle fractures, 45 pilon fractures, and 3 pure dislocations of the foot or ankle. Overall, 243 (83%) of these injuries underwent surgical fixation and data have shown that when surgery is used to manage high-energy injuries of the foot and ankle in the elderly individuals, the complications and outcomes are similar to those seen in younger patients. Therefore, the decision for surgical intervention for high-energy injuries of the foot and ankle should be based primarily on the injury pattern and not solely on the age of the patient. Keywords elderly, geriatric, high-energy injuries, foot and ankleThe 2010 census demonstrated that of the 308 million people living in the United States, 13% were aged 65 and older 1 and that, except for those in the 45 to 65 years bracket, this group grew at a faster rate than any other segment of the population. 2 Extrapolation data have estimated that by the year 2035, almost 20% of the US population of 389 million people will be 65 years and older. 3

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Chopart Joint Fracture-Dislocation: Initial Open Reduction Provides Better Outcome than Closed Reduction

Cited by 87 publications

References 18 publications

Salvage Arthrodesis for Fracture-Dislocation of the Cuneonavicular and Calcaneocuboid Joints: A Case Report

Salvage Arthrodesis for Fracture-Dislocation of the Cuneonavicular and Calcaneocuboid Joints: A Case Report

Isolated Dorsal Midtarsal (Chopart) Dislocation: A Case Report

Management of High-Energy Foot and Ankle Injuries in the Geriatric Population

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