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Orthopaedic Proceedings
Vol. 95-B, Issue SUPP_30 | Pages 41 - 41
1 Aug 2013
Winter A Ferguson K Macmillan J
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We present a case of a 14 year old who sustained an isolated injury to her foot while horse riding. X-rays demonstrated a medial and plantar dislocation at the level of the talo-navicular and calcaneo-cuboid joint, with associated fractures of the cuboid and navicular. This was treated initially with open reduction and fixation with kirschner wires as the injury was grossly unstable and reduction difficult to maintain with casting alone. CT scan was then performed prior which confirmed satisfactory reduction of the dislocation and fixation with the k wires so these were left in situ and the navicular fracture reduced and fixed with a barouk screw.

The Chopart joint was first described by French surgeon Francois Chopart as the talo-navicular and calcaneo-cuboid joints were a practical level for amputation. Injury here is a rare but missed in 40% at presentation. Pure dislocation occurs in 10–25% with most having concomitant fractures. The Chopart joint has critical role in balance and stability in normal gait. Early recognition allows prompt reduction and fixation of these injuries which has been associated with a better outcome. However these are severe injuries and patients should be counselled on potential long term functional impairment even with optimal management.