Operative Orthopädie und Traumatologie

, Volume 8, Issue 4, pp 279–286 | Cite as

The augmented chopart amputation in children

  • Merv Letts


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.

General anaesthesia.

Surgical Technique

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.

Postoperative Management

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.

Possible Complications


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 Words

Chopart amputation Tendon tranfer Syme's prosthesis 


Chopart-Amputation Sehnenverpflanzung Syme-Prothese 


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Copyright information

© Urban & Vogel 1996

Authors and Affiliations

  • Merv Letts
    • 1
  1. 1.Department of Surgery, Children's Hospital of Eastern OntarioUniversity of OttawaOttawaCanada

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