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Limb salvage with Chopart's amputation and tendon balancing
A M Reyzelman1, S Hadi, D G Armstrong
1California College of Podiatric Medicine, San Francisco, USA.
Journal of the American Podiatric Medical Association
|March 4, 1999
Summary
Chopart's amputation, when combined with tendon balancing, offers better function than more distal amputations. This technique minimizes equinovarus deformity, reducing ulceration risk for improved long-term outcomes.
Area of Science:
- Podiatric surgery
- Orthopedic surgery
- Biomechanics of the foot
Background:
- Chopart's amputation has faced skepticism due to potential equinus deformity.
- Distal amputations like Lisfranc or transmetatarsal can lead to functional deficits.
Purpose of the Study:
- To provide a rationale for the functional benefits of Chopart's amputation with tendon balancing.
- To discuss the foot's arch anatomy in relation to amputation level and deformity risk.
Main Methods:
- Review of the biomechanical principles of foot amputation.
- Analysis of tendon balancing techniques including anterior tibial tendon transfer and tendo Achillis lengthening.
- Discussion of the foot's longitudinal and transverse arch concepts.
Main Results:
- Appropriate tendon balancing can make Chopart's amputation more functional than distal amputations.
- Eliminating the cuboid in Chopart's amputation can prevent varus deformity.
- Shorter midfoot amputations increase the risk of equinovarus deformity and ulceration.
Conclusions:
- Chopart's amputation, with proper tendon balancing, can yield superior functional results.
- Understanding foot arch biomechanics is crucial for optimizing amputation outcomes.
- This approach mitigates risks associated with distal amputations, improving long-term patient results.