Entre los huesos de la 1ra. y 2da línea del tarso. Une el calcáneo al astrágalo. El cuboides al navicular. 2 articulaciones: lateral. Bóveda Plantar Antepié Arcos Longitudinales Arcos Transversales } Calcáneo- astrágalo-escafoides-primera cuña y primer metatarsiano. Articulación de Chopart o articulación mediotarsiana, formada por las que, como en el caso de Lisfranc, lleva su nombre asociado a una articulación del pie .
|Published (Last):||4 July 2010|
|PDF File Size:||19.14 Mb|
|ePub File Size:||20.73 Mb|
|Price:||Free* [*Free Regsitration Required]|
Joint stabilization with Kirschner wires 1,mm once the congruence is restored, may provide additional stability and could be performed after either open or close reduction.
J Bone Joint Surg Br ; Close reduction is a valid procedure in subluxations, acute dislocations when anatomy could be perfectly restored or in cases where surgery is contraindicated 5,9. A midtarsal joint aeticulacion in a year-old-woman is described, in which diagnosis was performed at 8 weeks of evolution.
Foot Anatomy and Biomechanics
She was treated with a bandage and acetaminophen 1 gram every eight hours and was allowed ongoing support weight bearing using two crutches. Both joints together with the subtalar joint are involved fundamentally in the inversion and eversion movements 5,6. The surgical correction of the length lisfrabc shape of the longitudinal arch is important and technically challenging especially in combined Chopart-Lisfranc injuries 9.
Also, good outcomes can be achieved performing initially a midtarsal arthrodesis, and this could represent the best solution in case of massive articular surface destruction.
Subsequently, the patient should begin gradual partial and controlled weigh bearing using a custom molded foot orthotics and crutches. Finally, the avulsion fracture of the dorsal talonavicular ligament caused by additional plantar flexion forced serves as radiological marker for serious ee injury with midtarsal instability CT offers additional information when associated lesions or to plan future treatments and is not hesitating to apply if diagnosis is unclear.
Furthermore, these injuries are frequently missed or misdiagnosed, often leading to a poor functional outcome 3. She immediately felt local pain and swelling. The patient reported, as the only history of interest, trauma eight articulcaion ago, in which she struck a heavy cabinet directly over the foot in plantar flexion. J Foot Ankle Surg ; Chopart fractures and dislocations. Loss of joint congruence and stability in this region jeopardizes the whole function of the lisfdanc and a normal chpart 7,8.
At 48 hours after surgery the patient was discharged, after skin condition and postoperative radiographs were controlled. Comparing lisfrranc outcomes between Chopart, lisfranc and multiple metatarsal shaft fractures. From that moment partial load bearing was allowed using an orthopedic hard-soled shoe with an orthotic medial arch support insole.
Lisfranc and Chopart injuries.
Articulation de Chopart — Wikipédia
Computed tomography CT was requested. In most of the cases are due to axial loads or torsional forces acting on the foot in plantar flexion. The injury severity was reported to the patient and a surgical reduction of the dislocation was scheduled for two days later.
Ip Ky, Lui Th. According to Klaue 10 we thought the double approach is the best way to treat these injuries by ensuring accessibility to both joints.
The reasons for misdiagnosis could be their low prevalence and the absence of obvious radiological signs in up to a third of cases 5, The intervention ended with the limb immobilization with a short leg cast. It exposes afticulacion the calcaneocuboidal joint. The patient had no foot pain either chopaft rest or walking, but referring some functional limitation when running. An alternative to this method of treatment may be external fixation, especially given the existence of serious soft tissue injury or when the lateral and medial columns are seriously fractured and shortened.
There was not swelling on the inspection, there were neither bruising nor skin changes. Inveterate dislocations are also an indication of open reduction.
Articulation de Chopart
The heterogeneity and complexity of midtarsal dislocations and fracture-dislocations hampers the existence of an international consensus classification. Clin Biomech ; It requires careful dissection and protection of the peroneus superficialis and suralis nerves Fig. Six weeks post-surgery, hardware and immobilization were removed. Another important marker of midfoot injury is the S-shaped Cyma line on lateral radiographs, sign of congruence of llsfranc talonavicular and calcaneocuboidal joints.
Hermel Mb, Gershon-Cohen J. The importance of being aware of midtarsal injuries. Main and Jowett 11 attempted to classify these injuries into five types according to the direction of the deforming force and the resulting displacement: An open reduction was performed by a double approach medial and lateral and a Kirschner wire joint stabilization.
Routine postoperative measures include rigid immobilization and no-weight bearing for a period of six to eight weeks.