1. Case for small group discussion
Chopart joint injury
Case for small group discussion
AOTrauma—Foot & Ankle
Module 4b: Midfoot trauma—Chopart, navicular fractures
Stefan Rammelt and Hans Zwipp, DE

2. Case description
22-year-old man
Fell from a scaffold (3 m)

3. Diagnosis What is the type and mechanism of the injury?
Is any further information needed?

4. Fracture mechanism Medial stress (adduction)
Lateral stress (abduction)
Plantar stress
Axial stress
Crush

5. Preoperative CT scans

6. Talar head and lateral process fracture and dislocation of the cuboid
How would you treat this fracture/dislocation?

7. Treatment
K-wires removed at 6 weeks Weight bearing gradually increased subsequently

8. 5 years and 3 months follow-up

9. Take-home messages Exact radiographic projections
High index of suspicion—CT scan
Look for injury in both columns of the foot
Transfixation for ligamentous instability
Restoration of medial and lateral column
References:
Rammelt S, Grass R, Schikore H, Zwipp H. [Injuries of the Chopart joint]. Unfallchirurg Apr;105(4):371–383; quiz 384–385. German.
Rammelt S, Zwipp H, Schneiders W, Heineck J. Anatomical reconstruction after malunited Chopart joint injuries. Eur J Trauma Emerg Med. 2010;36: 196–205.
Main BJ, Jowett RL. Injuries of the midtarsal joint. JBJS. 1975;57B:89–97.
Rammelt et al. Unfallchirurg. 2002;105:371–383.
Rammelt et al. Eur J Trauma Emerg Med. 2010;36:196–205.