Chopart’s Fracture-Dislocation

Chopart’s fracture dislocations are rare and highly complex injuries. They are generally caused by high-energy trauma. This results in compression fractures at the medial or lateral side which are most likely combined with distraction forces at the opposite side, named ¨nutcracker¨ phenomenon. A pathognomonic sign is the presence of a plantar ecchymosis that indicates the rupture of the strong plantar ligaments. CT scan is crucial to diagnose the exact fracture pattern and therefore plan an appropriate surgical treatment. Nonoperative treatment is reserved for nondisplaced and stable injuries like midfoot sprains, including stable ligamentous ruptures or bony avulsions around the Chopart’s joint. Dislocations must be reduced urgently. Definitive treatment consists of anatomical realignment of the axes and columns; this is crucial because any shift in the foot axis will alter gait biomechanics and lead to secondary osteoarthritis.