Abstract
Provision of a functional weight-bearing stump. Improved stability of ankle and subtalor joints. Prevention of developing an equinus deformity. Severely mangled or malformed foot. Severe bilateral foot and lower limb deformities. Limb length discrepancy. Inadequate plantar skin coverage. Significant loss of tendons. Gross instability at ankle or subtalar joint. Radiographs of foot and ankle. Careful examination of ankle and subtalar joints. Supine. Above knee tourniquet. General anaesthesia. Augmentation of the traditional Chopart amputation with transfer of the tibialis anterior, tibialis posterior, and long toe extensor tendons to the talus and lengthening of the heal cord. Compressive dressing to be changed after 3 weeks. Weight bearing is resumed after 6 weeks. Fitting of a modified Syme's prosthesis after 3 months. Haematoma. Pull out of transferred tendons. Skin flap necrosis. Infection. 6 patients have undergone this amputation, 2 of whom were amputated bilaterally. Follow-up: 5 years. All patients were able to bear full weight. In 1 child the foot drifted into a slight equinus not necessitating a repeat Achilles tendon lengthening.
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