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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Then it proceeded to carefully repair capsulo-ligamentous structures.

Foot Anatomy and Biomechanics

Delay in diagnosis is common and may adversely affect the long-term prognosis 3. The patient reported, as the only dw of interest, trauma eight weeks ago, in which she struck a heavy cabinet directly over the foot in plantar flexion. Close reduction is a valid procedure in subluxations, acute dislocations when anatomy could be perfectly restored or in cases cho;art surgery is contraindicated 5,9. Since then, the midtarsal joint is referred as Chopart joint.

She was immobilized with a cast and cited at the ambulatory trauma service.

Finally deserves special attention the combined Chopart and Lisfranc dislocation, rare but especially serious. Three months postoperatively may be the time to begin normal shoe wearing 5. On her second visit to ER also a not clear diagnosis was achieved. Foot Ankle Clin ; The combined Chopart-Lisfranc lesion seems to present significantly worse results. The intervention ended with the limb immobilization with a short leg cast.


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The nutcracker fracture of the cuboid by indirect violence. We recommend using orthotic insoles providing longitudinal arch support in order to prevent loss of reduction after starting to walk. In most of the cases are due articulacionn axial loads or torsional forces acting on the foot in plantar flexion.

Under fluoroscopic control it was performed percutaneous osteosynthesis with Kirschner wires through both joints. Complejo Hospitalario de Navarra.

Instr Course Lect ; It is composed of the condyloid talonavicular joint and the saddle-shaped calcaneocuboidal joint. An open reduction was performed by a double approach medial and lateral and a Kirschner wire joint stabilization.

Secondly, several key points for a proper diagnosis are given with the aim of reducing cases of misdiagnosis. Tibiotalar cjopart mobility was preserved, and no painful. Am J Roentgenol ; Both approaches are safe and allow proper display of the key elements. Besides describing the treatment of this particular injury, this study is aimed at increasing the level of clinical suspicion in order to avoid misdiagnosis xe as occurred in our case.

The importance of being aware of midtarsal injuries. The cuboid and distal calcaneus fractures, typically associated to midtarsal dislocations, produced by forced abduction or adduction lateral or medial stress are known as Nutcracker fractures.


Main Bj, Chlpart Rl. Chopart dislocations with associated injuries, open reduction and fracture fixation represents the best option and allow reparation of damaged capsulo-ligamentous structures.

Avulsion fracture of the dorsal talonavicular ligament: CT offers additional information when associated lesions or to plan future treatments and is not hesitating to apply if diagnosis is unclear. Joint stabilization with Kirschner wires 1,mm once the congruence is restored, may provide additional stability and could be performed after either open or close reduction.

The midtarsal is a low mobile but essential joint for proper mechanics and architecture of the foot. Exercises that strengthen and stretch the gastrocnemius should be emphasized to the patient. J Bone Joint Surg Br ; 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 In conclusion, handling Chopart injuries is challenging and even more in the delay setting.

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.