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 .
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Arch Orthop Trauma Surg ; They can be pure dislocations i. Chopart dislocations with associated injuries, open reduction and fracture fixation represents the best option and allow reparation of damaged capsulo-ligamentous structures.
Given ds poor evolution, with persistent pain and walking impairment, the patient returned to the ER at 6 weeks of the trauma suffered. Both approaches are safe and allow proper display of the key elements. On her second visit to ER also a not clear cohpart was lisfeanc. Main and Jowett 11 attempted to classify these injuries into five types according to the direction of the deforming force and the resulting displacement: The importance of being aware of midtarsal injuries.
The frequency is by far the highest for the medial and plantar dislocations. It is composed of the condyloid talonavicular joint articulacikn the saddle-shaped calcaneocuboidal joint. Past 12 months after surgery loss of reduction was not observed. Secondly, several key points for a proper diagnosis are given with the aim of reducing cases of misdiagnosis. The patient reported, as the only history of interest, trauma eight weeks ago, in which she struck a heavy cabinet directly over the foot in plantar flexion.
Foot Anatomy and Biomechanics
In most of the cases are due to axial loads or torsional forces acting on the foot in plantar flexion. Obtaining radiographs of the foot in three projections anteroposterior, lateral and oblique is essential. The ultimate goal is to restore alignment and length in both columns of the foot, medial and lateral, getting proper congruence in the joints and ligamentous stability.
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. Classification and epidemiology of mid-foot fractures.
Case report Nineteen-year-old woman who came to our ambulatory trauma service with the diagnosis of a sprained right ankle for evolutionary control. Foot Ankle Int ; Often, these lesions occur in cases presenting a varus-cavus foot morphotype We hope the reported case may articulacioh helpful to orthopedic surgeons facing similar cases and increasing awareness about this rare but serious entity.
Computed tomography CT was requested. Finally deserves special attention the combined Chopart and Lisfranc dislocation, rare but especially serious.
Articulation de Chopart — Wikipédia
In cases of poor outcome and at the persistence of pain will be indicated salvage procedures including osteotomies and arthrodesis. In the delayed setting careful debridement of the Chopart space is essential. La importancia de reconocer las lesiones mediotarsianas.
Clin Biomech ; Also, good outcomes can be achieved performing initially a midtarsal arthrodesis, and this could represent the dd solution in case of massive articular surface destruction. Another important marker of midfoot injury is the S-shaped Cyma line on lateral radiographs, sign of congruence of the talonavicular and calcaneocuboidal joints. Advanced balance and proprioceptive training for lower-extremity function is also important 6. The present study has several objectives.
Artrologia Tobillo y pie
CT offers additional information when associated lesions or to plan future treatments and is not hesitating to apply if diagnosis is unclear. We recommend using orthotic insoles providing longitudinal arch support in order to prevent loss of reduction after starting to walk.
In the present study a midtarsal joint dislocation of eight weeks of evolution is reported which it was reduced through a double medial and lateral approach. Ankle and foot injuries: A midtarsal joint dislocation in a year-old-woman is described, in which diagnosis was performed at 8 weeks of evolution.
Greater series reported 3,7,9 agree on a set of conclusions in terms of outcomes but they all refer to acute lesions. Foot ankle Int ; The main causes of midtarsal dislocation are motor vehicle accidents and falls from a height 3,9. It exposes perfectly the calcaneocuboidal joint. Isolated dorsal midtarsal Chopart dislocation: 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.
Foot Ankle Clin ; Finally, the avulsion fracture of the dorsal talonavicular ligament caused by additional plantar flexion forced serves as radiological marker for serious ligamentous injury with midtarsal instability Complejo Hospitalario de Navarra.
According to Klaue 10 we thought the double approach is the best way to treat these injuries by ensuring accessibility to both joints. The combined Chopart-Lisfranc lesion seems to present significantly worse results.
Instr Course Lect ;