The augmented chopart amputation in children
Goal of Surgery
Provision of a functional weight-bearing stump. Improved stability of ankle and subtalor joints. Prevention of developing an equinus deformity.
Severely mangled or malformed foot.
Severe bilateral foot and lower limb deformities.
Limb length discrepancy.
Inadequate plantar skin coverage.
Significant loss of tendons.
Gross instability at ankle or subtalar joint.
Preoperative Work Up
Radiographs of foot and ankle.
Careful examination of ankle and subtalar joints.
Positioning and Anaesthesia
Above knee tourniquet.
Augmentation of the traditional Chopart amputation with transfer of the tibialis anterior, tibialis posterior, and long toe extensor tendons to the talus and lengthening of the heal cord.
Compressive dressing to be changed after 3 weeks.
Weight bearing is resumed after 6 weeks.
Fitting of a modified Syme's prosthesis after 3 months.
Pull out of transferred tendons.
Skin flap necrosis.
6 patients have undergone this amputation, 2 of whom were amputated bilaterally.
Follow-up: 5 years. All patients were able to bear full weight. In 1 child the foot drifted into a slight equinus not necessitating a repeat Achilles tendon lengthening.
Key WordsChopart amputation Tendon tranfer Syme's prosthesis
SchlüsselwörterChopart-Amputation Sehnenverpflanzung Syme-Prothese
Unable to display preview. Download preview PDF.
- 2.Boyd, H. B.: Amputation of the foot with calcaneotibial arthrodesis. J. Bone Jt Surg. 21-A (1939), 997–1000.Google Scholar
- 3.Christie, J., C. B. Clowes, D. W. Lamb: Amputations through the middle part of the foot. J. Bone Jt Surg. 62-B (1980), 473–474.Google Scholar
- 4.Greene, W. B., J. M. Cary: Partial foot amputations in children. J. Bone Jt Surg. 64-A (1982), 438–443.Google Scholar
- 6.Kofmann, V.: Exarticulatio inter-tibio-calcanea and its functional result. J. Bone Jt Surg. 21 (1939), 521.Google Scholar
- 7.Kritter, A. E.: A technique for salvage of the infected diabetic gangrenous foot. Orthop. Clin. N. Amer. 4 (1973), 21–30.Google Scholar
- 11.MacDonald, A.: Chopart's amputation. J. Bone Jt Surg. 37-B (1955), 468–470.Google Scholar
- 12.Parziale, J. R., K. A. K. Hahn: Functional considerations in partial foot amputations. Orthop. Rev. 27 (1988), 262.Google Scholar
- 13.Paterson, R.: Memorial of the life of James Syme. Edmonton and Douglas, Edinburgh 1874.Google Scholar
- 14.Ricard, A., P. Launey: Technique chirurgicale 2. Octabe Doin, Paris 1905, p. 251.Google Scholar
- 16.Tooms, R. E.: Amputations. In: Edmonson, A. S., A. H. Crenshaw (eds.): Campbell's operative orthopaedics, 6th ed. C. V. Mosby, St. Louis 1986, p 821–872.Google Scholar
- 17.Vitali, M., K. P. Robinson, B. G. Andrews, E. C. Harris: Below-knee amputations and prosthesis. Bailliere Tindall, London 1978.Google Scholar