Case note-a combined end-bearing and patellar-tendon-bearing prosthesis for Chopart's amputation

Disarticulation between the proximal talus and calcaneous, and the distal navicular and cuboid (Chopart's disarticulation) was probably first performed in Britain by Syme in Edinburgh in 1829. Although initially successful, it fell into disrepute because of equinus deformity that developed as a result of the unopposed action of the soleus-gastrocnemius muscles and tendoachilles on the os calcis. Callosities and corns developed on the anterior aspect of the skin flap. These could become rather painful and troublesome at times. Nevertheless, it is an operation that is performed occasionally, and has a place in the range of conservative distal amputations of the lower limb. Whatever the views of the prosthetic team, they may be faced with a surgical "fait accompli" for which they have to provide a suitable prosthesis. There are various prostheses available but we describe a prosthesis required to fulfil a cosmetic, functional and combined end-bearing and patellar-bearing need.