[Chopart dislocation--a simple diagnosis?]

The case of an initially overlooked transligamentary Chopart dislocation following distorsion trauma of the foot is presented and the treatment and long-term course are discussed. A 55-year-old female patient sustained severe injury to the left foot after falling from a height of 4 m.. The instep was severely swollen and there was deformity with adduction of the forefoot and supination position. The peripheral pulse and sensitivity were intact. The conclusion from local radiographic investigations was that there were no signs of fracture or dislocation. The patient travelled home in pain 1 week after the accident and registered in the casualty department at our hospital. Assessment of the radiographs revealed a transligamentary Chopart dislocation with dorsolateral dislocation of the talus head, avulsed navicular fragments and a depressed fracture at the medial talus head. Treatment was initiated immediately after diagnosis with closed reduction and percutaneous K-wire fixation and 8 weeks immobilization in a lower leg plaster cast. Chopart dislocation is a rare consequence of accidental distortion trauma of the foot. Peritarsal dislocations represent approximately 15% of tarsal injuries and 1% of joint dislocations overall. Therefore, if a high energy accident has occurred, it is necessary to specifically search for dislocations and fractures. Immediate reduction reduces the risk of complications.