Neglected medial swivel talonavicular dislocation treated with arthrodesis: A case report and literature review

Kumar, Arvind; Gaba, Sahil; Digge, Vijay Kumar; Gautam, Deepak

doi:10.1016/j.jcot.2018.12.011

Cited by 3 publications

(2 citation statements)

References 9 publications

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“…For malunited Chopart fracture-dislocations, secondary reconstruction improves outcomes in suitable patients otherwise joint fusion is required [ 13 ]. Arthrodesis is implemented in late presentations [ 24 ], in patients with diabetic arthropathy [ 25 ], or when other treatment strategies have failed where arthrodesis can prevent midfoot collapse [ 26 ]. TNJ Arthrodesis can reduce the Chopart joint range of motion by 50% and is a negative prognostic factor [ 15 ], so is considered a last resort [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

Chopart dislocations: a review of diagnosis, treatment and outcomes

Metcalfe,

Aamir,

Mason

2023

Arch Orthop Trauma Surg

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Introduction Chopart injuries can be allocated into 4 broad groups, ligamentous injury with or without dislocation and fracture with or without dislocation, which must occur at the talonavicular joint (TNJ) and/or calcaneocuboid joint (CCJ). Chopart dislocations are comprised of pure-dislocations and fracture-dislocations. We aim to review the literature, to enable evidence-based recommendations. Methods A literature search was conducted to identify relevant articles from the electronic databases, PubMed, Medline and Scopus. The PRISMA flow chart was used to scrutinise the search results. Articles were screened by title, abstract and full text to confirm relevance. Results We identified 58 papers for analysis, 36 case reports, 4 cohort studies, 4 case series and 14 other articles related to the epidemiology, diagnosis, treatment and outcomes of Chopart dislocations. Diagnostic recommendations included routine imaging to contain computed tomography (CT) and routine examination for compartment syndrome. Treatment recommendations included early anatomical reduction, with restoration and maintenance of column length and joint congruency. For both pure-dislocations and fracture-dislocations urgent open reduction and internal fixation (ORIF) provided the most favourable long-term outcomes. Conclusions Chopart dislocations are a complex heterogenous midfoot injury with historically poor outcomes. There is a relative paucity of research discussing these injuries. We have offered evidence-based recommendations related to the clinical and surgical management of these rare pathologies.

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Section: Discussionmentioning

confidence: 99%

Chopart dislocations: a review of diagnosis, treatment and outcomes

Metcalfe,

Aamir,

Mason

2023

Arch Orthop Trauma Surg

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“…Subtalar subluxation may be radiographically evident due to the calcaneus rotation or swivel, on the intact interosseous talocalcaneal ligament in the sinus tarsi, beneath the talus, taking with it the cuboid. A wide variety of ankle or foot fractures have been recorded in the reported patients with swivel dislocations, which have all been detected in adults with a minimum age of 18 years [102][103][104][105][106][107][108][109][110][111][112][113][114][115][116][117][118][119] .…”

Section: Reviewmentioning

confidence: 99%

Subtalar and Chopart Dislocations in Children and Adolescents

Sferopoulos¹

2020

J Orthopedics & Orthopedic Surg

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Subtalar and Chopart dislocations are extremely rare in childhood but become slightly more common in older children and adolescents. Subtalar dislocation involves dislocation of the subtalar and talonavicular joints, with intact tibiotalar and calcaneocuboid joints, in the absence of a talar neck fracture. It should be differentiated from the Chopart dislocation and from traumatic entities presenting radiographically as isolated talonavicular dislocations. Chopart joint injury involves the talonavicular and calcaneocuboid joints of the foot. The injury may appear as sprain, fracture, subluxation or dislocation. Diagnosis is made on plain radiographs; although initial views may not reveal the severity of the lesion, since spontaneous reduction may occur. The radiographic detection of an isolated talonavicular dislocation is probably indicative of a Chopart joint injury, in which a momentary subluxation or dislocation of the calcaneocuboid joint has occurred. The differential diagnosis of a radiographically detected isolated talonavicular dislocation should also include traumatic entities associated with intact calcaneocuboid joint, such as the swivel talonavicular dislocation and the isolated displacement of only the medial part of the Chopart joint. The swivel talonavicular dislocation is a subtype of the Chopart joint injury, in which the foot with the calcaneus is rotated beneath the talus, producing subtalar subluxation but not dislocation. In the isolated displacement of only the medial part of the Chopart joint the subtalar joint is not injured. The injury is usually associated with a fracture of the body of the tarsal navicular and it is believed to be the result of severe abduction or adduction of the forefoot. Subtalar dislocations and Chopart joint injuries in children and adolescents seem to be comparable with their adult counterparts in the mechanism of injury, classification, treatment, complications and outcome. The challenges in treating these injuries are to achieve adequate diagnosis and prompt treatment. It appears mandatory that obtaining and maintaining an early anatomic reduction remains the key factor in achieving good outcomes. However, a high incidence of complications, such as compartment syndrome, soft tissue compromise, avascular necrosis of bone, bone growth deformities and debilitating early post-traumatic arthritis, have been reported. The purpose of this report is to review the relevant publications on subtalar and Chopart dislocations in children and adolescents and to present illustrative cases treated at our institution.

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