Anatomic reconstruction of malunited Chopart joint injuries.

Fractures and dislocations at the mid-tarsal (Chopart) joint are frequently overlooked or misinterpreted at first presentation. Inadequate joint reduction and stabilization almost invariably lead to painful malunions or nonunions, residual instability, and deformity. Because of the central position...

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Publicado en:European Journal of Trauma & Emergency Surgery Vol. 36; no. 3; pp. 196 - 206
Autores principales: Rammelt S, Zwipp H, Schneiders W, Heineck J
Formato: diagnostic images pictorial research Journal Article
Publicado: Springer Nature Jun2010
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jun2010
      vid: 36
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      pub: Springer Nature
      place: New York, New York
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        2010686695
        10.1007/s00068-010-1036-3
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        atl: Anatomic reconstruction of malunited Chopart joint injuries.
      aug:
        au:
          Rammelt S
          Zwipp H
          Schneiders W
          Heineck J
        affil: Trauma and Reconstructive Surgery, University Hospital Carl Gustav Carus, Fetscherstr. 74, 01307 Dresden, Germany; strammelt@hotmail.com
      sug:
        subj:
          Foot Injuries Complications
          Fractures, Malunited Surgery
          Surgery, Reconstructive Methods
          Adolescence
          Adult
          Case Studies
          Descriptive Statistics
          Diagnostic Errors
          Dislocations
          Female
          Foot Anatomy and Histology
          Foot Physiology
          Human
          Male
          Middle Age
          Osteonecrosis Risk Factors
          Outpatients
          Patient Satisfaction
          Postoperative Complications
          Surgery, Reconstructive Adverse Effects
          Treatment Outcomes
          Adolescent: 13-18 years
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Female
          Male
      ab: Fractures and dislocations at the mid-tarsal (Chopart) joint are frequently overlooked or misinterpreted at first presentation. Inadequate joint reduction and stabilization almost invariably lead to painful malunions or nonunions, residual instability, and deformity. Because of the central position and the essential function of the mid-tarsal joint, malunions lead to a considerable impairment of global foot function and the rapid development of posttraumatic arthritis. While secondary anatomical reconstruction with joint preservation would be desirable in order to restore normal foot function, it is amenable only if no symptomatic arthritis or avascular necrosis is present. Over a course of 6 years, eight patients have been treated with secondary correction, joint realignment, and internal fixation. In four of these cases, nonunions of the tarsal navicular were debrided and bone-grafted; in the remaining cases, a corrective osteotomy at the navicular or cuboid was carried out. At 2 years follow-up, all but one patient were satisfied with the result. One patient underwent fusion of the talonavicular joint for avascular necrosis and collapse of the navicular. The mean American Orthopaedic Foot and Ankle Score (AOFAS) improved significantly from 38.8 preoperatively to 80.8 at follow-up. However, the majority of malunited mid-tarsal fracture-dislocations will require corrective fusion of the affected joint(s) with axial realignment because of manifest posttraumatic arthritis at the time of patient presentation.
      pubtype: Academic Journal
      doctype:
        diagnostic images
        pictorial
        research
        Journal Article
      ougenre: Article
    language: English
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