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BODYCAST - THE OFFICIAL JOURNAL OF THE CSOT Chopart fractures By Kaj Klaue Reprinted with permission from Injury Int. J. Care Injured (2004), 35(Supp. 2), S-B64-S-B70 Summary The Chopart articular space was described by Francois 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 cova 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 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 indicate to restore the “coax pedis”. Open reconstruction or fusion in correct length of the calcaneocuboidal joint is occasionally indicated. Salvage procedures in malunions includes navicular osteotomies and calcaneo-cuboidal bone block fusions. Treatment of the joint destructions, especially involving the talo-navicular joint, includes triple arthrodesis. Anatomy and function The talo-navicular and the calcaneo-cuboidal joints form an articular space that crosses the whole foot thus providing a technically easy location for amputations. This space was described by Francois Chopart (1743-1795) as a practical space for amputations in cases of distal foot necrosis (Fourcroy, A.F., 1792). In a healthy and fully functional foot and ankle, both the talo-navicular and calcaneo-cuboidal joints have very different functions. The talo-navicular joints belongs to the talo-calcaneo,navicular joint (coax pedis) (Scarpa, A., 1839), which is essential for pronation and supination of the whole foot. The calcaneo-cuboidal joint, which has its own articular chamber, adapts the lateral column of the foot to the plantar buttress. Its function is thus more discrete, adding flexibility to the osteoarticular structure and suspension to the pulley of the long peroneus tendon. This abstract is a portion of the article
which appears in the Summer 2005 issue of BodyCast. |
