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Lisfranc and Chopart amputation: A systematic review
Gesiena E van der Wal1, Pieter U Dijkstra1,2, Jan H B Geertzen1
1University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Center of Rehabilitation, The Netherlands.
Lisfranc and Chopart amputations show varied outcomes. Modified Chopart and Lisfranc amputations are recommended over conventional Chopart due to better wound healing and ambulation potential.
Area of Science:
- Orthopedic surgery
- Podiatric surgery
- Amputation outcomes
Background:
- Lisfranc and Chopart amputations are controversial surgical procedures.
- Evidence on wound healing, re-amputation rates, and ambulation post-amputation is needed.
Approach:
- Systematic review of 4 databases (Cochrane, Embase, Medline, PsycInfo).
- Included 16 studies from 2881 publications after applying exclusion criteria.
- Analyzed wound healing, re-amputation needs, and ambulation.
Key Points:
- Failed wound healing rates: 20% (Lisfranc), 28% (modified Chopart), 46% (conventional Chopart).
- Short-distance ambulation without prosthesis: 85% (Lisfranc), 74% (modified Chopart).
- Unlimited household ambulation: 26% (conventional Chopart).
Conclusions:
- Conventional Chopart amputation has the highest re-amputation rate due to wound healing issues.
- Lisfranc and modified Chopart amputations offer functional residual limbs and short-distance ambulation.
- Consider Lisfranc and modified Chopart amputations before higher-level amputations; further research on predictive patient characteristics is warranted.
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