1. Case for small group discussion
Midfoot injury
Case for small group discussion
Complex midfoot deformity
AOTrauma—Foot & Ankle
Module 4b: Midfoot trauma—Chopart, navicular fractures
Stefan Rammelt, DE

2. Case description 58-year-old man
Sprained his foot when jumping from a truck

3. Discussion What is the type of injury? Is any more information needed?
Diagnosed as “midfoot sprain”
Not good enough x-rays as midfoot not evaluated adequately

4. 12 weeks post injury Still painful at the midfoot
Someone marked something on the x-ray but did not take any further action

5. Discussion
What could have been done at this point?

6. 18 months post injury Weight-bearing x-ray
Patient walking on crutches with a big boot and in severe pain

7. 18 months post injury
Dorsoplantar weight-bearing x-ray
Standing

8. Postoperative x-rays
Arthrodesis to correct deformity
Standing

9. Correction
Preoperative
Standing
2 years postoperative

10. Correction
Preoperative
2 years postoperative
Standing

11. Take-home messages
Chopart joint injuries are frequently missed or underestimated
With fracture on one column, always suspect at least ligamentous injury to the other column
Restore column length
Restrict fusion to arthritic joints
Rammelt et al. Eur J Trauma Emerg Med. 2010;36:196–205