Treatment of Chopart joint fracture-dislocation with external mini-fixator and limited internal fixation

Abstract

Objective To evaluate the clinical treatment of Chopart fracture-dislocation with external mini-fixator and limited internal fixation. Methods From May 2006 to January 2008, 15 feet with Chopart fracture-dislocation were treated with external mini-fixator and limited internal fixation. The frac-ture-dislocation was treated with open reduction and internal fixation while the lengths of the medial and lateral columns of the foot were maintained by external mini-fixator. Functional exercises were encouraged under the doctors' instructions and regular follow-ups were carried out with X-ray examination. Three months after op-eration the fixation devices and implants were removed to evaluate the clinical results with the American Or-thopaedic Foot & Ankle Society(AOFAS) for the midfoot. Results Three patients were lost to the fol-low-up and the others were followed up for an average of 15 (11 to 24) months. Their average AOFAS scores were 68.6±3.9 at 3 months after surgery, 72.9±2.6 at 6 months, and 77.5±4.6 at 12 months. All of them were capable of independent walking with no need for further treatment. Conclusions External mini-fixation combined with limited internal fixation is an effective treatment for Chopart fracture-dislocation. Besides the anatomical reduction of the fracture-dislocation, special attention should be paid to restoring lengths of the medial and lateral columns of the foot. Key words: Chopart joint; Fracture; Dislocation; Fracture fixation