The Treatment And Efficicy Of Chopart Joint Injury

Objective:To investigate the damage mechanism, treatment and clinical curative effect of Choaprt joint injury.Methods:Sixteen patients with Chopart joint injury were treated in our department from June2010to June2013,There were12males and4males,with an average age of27.5years(range,19to43years), Among them,Fourteen patients were open injury,The other were closed injury.According to the classification of Main and Jowett,The patients were divided into5types,From type I to type V,There were6patients,3patients,3patients,2patients,2patients,According to the classification of Gustilo,Two patients with open injury were divided into Type I and Type Ⅱ.Different reduction and fixation were done by different types of fracture and dislocation,The patient would be told about the postoperative guidance of recovery and regular reexamination,After3month The bone healing was detected,The external fixation or internal fixation could be taken out,Use of the American association of ankle surgery (American Orthopaedic Foot&Ankle Society, AOFAS) grading system to evaluate the clinical curative effect.Results:Four patients were lost to the follow-up and the others were followed up for average of14months(range,6to22months),Their average AOFAS scores were36.92±6.42before the operation,48.67±8.11at6months after surgy,61.25±6.40at9months,71.33±5.53at12months,the excellent and good rate was75%, One patients’s review X-ray shows the internal fixation loosening at6months follow-up, By taking out the internal fixation the patient felt no discomfort,Seven patients had the normal life,Two patients can walk without crutch and2can walk with crutch. One patients’s review X-ray shows the traumatic arthritis of the subtalar joint and calcaneocuboid joint, Through the arthrodesis of the two joint,the patient feel the relidf of pain and can walk without crutch. The results were significantly different about the AOFAS score of the pre-operation and6month after operation,6month and9month after operation,9month and12month after operation(P<0.05). Conclusion:Chopart joint injury need maintain the length of the medial column and lateral column,give priority to reduction the talonavicular jonit and secondly the calcaneocuboid,restore the core joint mobility,choose the appropriate fixations, Chopart joint injury would obtain satisfactory clinical efficacy.