Chopart, Pirogoff and Syme Amputations: A Survey of Twenty-one Cases

Ilizarov External Frame Technique for Pirogoff Amputations With Ankle Disarticulation and Tibiocalcaneal Fusion

“…3,10,13,16 With the Ilizarov frame, we achieved TCA union in all of the patients in the current study (except 1 86 50 14 10 0 3 77 Good 3 84 40 14 6 3 3 66 Good 4 79 40 8 6 3 3 60 Good 5 76 55 18 10 3 3 89 Excellent 7 66 50 18 10 3 3 84 Excellent 9 50 30 10 6 3 0 49 Fair 12 50 60 20 8 3 3 94 Excellent 14...…”

“…Therefore, the failure rate of the Pirogoff procedure (up to 30%) is mostly related to nonunion and/or persistent infection due to the osteosynthesis. 3,13,16 The purpose of this study was to review our experience with the use of the Ilizarov external frame as a technique for Pirogoff amputations with ankle disarticulation and tibiocalcaneal fusion. Particular attention was paid to potential risk factors, procedure-specific complications, and functional outcomes.…”

“…17 However, problems with heel pad migration, greater leg length discrepancies (as much as 8 cm), and high wound infection rates have also been described. [13][14][15]17,20 The Pirogoff amputation combines the advantages of a preserved heel pad with minimal loss of leg length. Despite the advantages of maximizing leg length preservation, which allows walking for short distances without a prosthesis, the Pirogoff amputation is not widely performed.…”

The “Flap-Shaft” Prosthesis for Insensate Feet with Chopart or Lisfranc Amputations

“…13,27 Furthermore, proper prosthetic fitting for large and bulbous stumps is difficult. 10,15,26 If an amputation of the foot is needed proximal to the transmetatarsal level, a Syme or below-knee amputation has been suggested to be functionally superior to a Chopart or Lisfranc amputation. 9,11,13 Considering amputations of the lower limb in general, the lowest possible amputation level is aimed for based on tissue viability to preserve as much function as possible.…”

Factors Associated With Successful Chopart Amputation in Patients With Diabetes

“…[13][14][15][16][17][18][19][20][21][22][23][24] In addition to the musculoskeletal contractures, shoeing of the residual limb was difficult as loss of the midfoot and forefoot did not allow for return to normal shoe gear without some form of bracing that involved the lower leg. 1,9,[25][26][27][28] MacDonald, 29 in 1955, was the first to advocate routine prosthetic use postoperatively. Ambulation and cadence in Chopart amputees have been shown to closely resemble that of nonamputees with the use of a highprofile prosthetic device, such as a patellar tendon-bearing brace or a Charcot Restraint Orthotic Walker (CROW).…”