Abstract

Dislocations and fracture-dislocations of the mid-tarsal (Chopart) joint are severe injuries that are often misjudged or underestimated with respect to their deleterious effects on foot function when treated improperly. Knowledge of the exact radiographic projections is essential for making the diagnosis. For preoperative planning the routine use of computed tomographic scanning is suggested. Classification ofChopart fracture-dislocations is based on the proposed pathomechanics, the direction of dislocating force and fractured bony components. The classic mechanism of injury is forced adduction or abduction (medial or lateral stress) mostly in combination with axial force. In any case of isolated navicular or cuboid compression fractures a corresponding ligamentous injury to the other side of the mid-tarsal joint has to be ruled out by stress films. The basic treatment principles ofChopart fracture-dislocations are realignment of the medial and lateral foot columns, restoration of joint congruity and temporal transfixation to ensure proper ligament healing in case of ligamentous instability.

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