Missed Chopart dislocation. The importance of being aware of midtarsal injuries

Authors

  • I. Sancho González Hospital Reina Sofía, Tudela
  • M. Menéndez García Complejo Hospitalario de Navarra, Pamplona, Navarra

DOI:

https://doi.org/10.23938/S1137-6627/2016000100019

Keywords:

"Fracture". "Dislocation". "Midtarsal". "Delayed Diagnosis". "Open Reduction".

Abstract

            Chopart (midtarsal) joint dislocations are relatively rare but potentially serious injuries. Their low prevalence and the possible absence of evident radiological findings cannot justify misdiagnosis because an adequate and correct treatment is required to achieve a proper clinical outcome.

             A midtarsal joint dislocation in a 19-year-old-woman is described, in which diagnosis was performed at 8 weeks of evolution. An open reduction was performed by a double approach (medial and lateral) and a Kirschner wire joint stabilization. At one-year of follow-up, loss of reduction was not observed and the patient was pain-free, although she referred to functional limitation when running.

             Besides describing the treatment of this particular injury, this study is aimed at increasing the level of clinical suspicion in order to avoid misdiagnosis such as occurred in our case.

             Key words. Fracture. Dislocation. Midtarsal. Delayed diagnosis. Open reduction.

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Author Biographies

I. Sancho González, Hospital Reina Sofía, Tudela

FEA Servicio de COT, H.Reina Sofía Tudela

M. Menéndez García, Complejo Hospitalario de Navarra, Pamplona, Navarra

FEA Servicio de COT, CHN

References

1. FOURCROY AF. La médecine éclairée par les sciences physiques 1972; Tomo 4 París: 85-88.

2. COURT-BROWN, CM, ZINNA S, EKROL I. Classification and epidemiology of mid-foot fractures. Foot 2006; 16: 138-141.

https://doi.org/10.1016/j.foot.2006.03.003

3. VAN DORP KB, DE VRIES MR, VAN DER ELST M, SCHEPERS T. Chopart joint injury: A study of outcome and morbidity. J Foot Ankle Surg 2010; 49: 541-545.

https://doi.org/10.1053/j.jfas.2010.08.005

4. KITAOKA HB, ALEXANDER IJ, ADELAAR RS, NUNLEY JA, MYERSON MS, SANDERS M et al. Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes. Foot ankle Int 1994; 15: 349-353.

https://doi.org/10.1177/107110079401500701

5. BENIRSCHKE SK, MEINBERG EG, ANDERSON SA, JONES CB, COLE P. Fractures and dislocations of the midfoot: Lisfranc and Chopart injuries. Instr Course Lect 2013; 62: 79-91

6. SWORDS MP, SCHRAMSKI M, SWITZER K, NEMEC S. Chopart fractures and dislocations. Foot Ankle Clin 2008; 13: 679-693.

https://doi.org/10.1016/j.fcl.2008.08.004

7. KÖSTERS C, BOCKHOLT S, MÜLLER C, WINTER C, ROSENBAUM D, RASCHKE MJ et al. Comparing the outcomes between Chopart, lisfranc and multiple metatarsal shaft fractures. Arch Orthop Trauma Surg 2014; 134: 1397-1404.

https://doi.org/10.1007/s00402-014-2059-8

8. MITTLMEIER T, KROWIORSCH R, BROSINGER S, HUDDE M. Gait function after fracture-dislocation of the midtarsal and/or tarsometatarsal joints. Clin Biomech 1997; 12: 16-17.

https://doi.org/10.1016/S0268-0033(97)88330-1

9. RICHTER M, THERMANN H, HUEFNER T, SCHMIDT U, GOESLING T, KRETTEK C et al. Chopart joint fracture-dislocation : initial open reduction provides better outcome than closed reduction. Foot Ankle Int 2004; 25: 340-348.

https://doi.org/10.1177/107110070402500512

10. KLAUE K. Chopart fractures. Injury 2004; 35: 64-70.

https://doi.org/10.1016/j.injury.2004.07.013

11. MAIN BJ, JOWETT RL. Injuries of the midtarsal joint. J Bone Joint Surg Br 1975; 57: 89-97.

https://doi.org/10.1302/0301-620X.57B1.89

12. IP KY, LUI TH. Isolated dorsal midtarsal (Chopart) dislocation: a case report. J Orthop Surg (Hong Kong) 2006; 14: 357-359.

https://doi.org/10.1177/230949900601400327

13. HERMEL MB, GERSHON-COHEN J. The nutcracker fracture of the cuboid by indirect violence. Radiology 1953; 60: 850-854.

https://doi.org/10.1148/60.6.850

14. HAAPAMAKI VV, KIURU MJ, KOSKINEN SK. Ankle and foot injuries: analysis of MDCT findings. Am J Roentgenol 2004; 183: 615-622.

https://doi.org/10.2214/ajr.183.3.1830615

15. SCHMITT JW, WERNER CML, OSSENDORF C, WANNER GA, SIMMEN H-P. Avulsion fracture of the dorsal talonavicular ligament: A subtle radiographic sign of possible Chopart joint dislocation. Foot Ankle Int 2011; 32: 722-726.

https://doi.org/10.3113/FAI.2011.0722

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Published

2016-04-29

How to Cite

1.
Sancho González I, Menéndez García M. Missed Chopart dislocation. The importance of being aware of midtarsal injuries. An Sist Sanit Navar [Internet]. 2016 Apr. 29 [cited 2025 Dec. 15];39(1):153-8. Available from: https://recyt.fecyt.es/index.php/ASSN/article/view/38365

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Section

Clinical notes

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