Chopart fractures

Abstract

The Chopart articular space was described by François Chopart (1743-1795) as a practical space for amputations in cases of distal foot necrosis. It corresponds to the limit between the anatomical hind-foot and the mid-foot. The bones involved are the talus and the calcaneus proximally, and the navicular and the cuboid distally. This space thus holds two functionally distinct entities, the anterior part of the coxa pedis (an essential functional joint) and the calcaneo-cuboidal joint,which can be considered to be an "adaptive joint" within a normal foot. Trauma to this region may cause fractures and/or dislocations and, in high energy trauma,compartment syndromes. Principles of treatment are immediate reduction of dislocations and realignment of the medial and lateral column of the foot in length and orientation. Open reduction and internal fixation of talus and navicular fractures are often indicated to restore the "coxa pedis". Open reconstruction or fusion in correct length of the calcaneo-cuboidal joint is occasionally indicated. Salvage procedures in malunions include navicular osteotomies and calcaneo-cuboidal bone block fusions. Treatment of joint destructions, especially involving the talo-navicular joint, include triple arthrodesis.