van Dorp Karin B, de Vries Mark R, van der Elst Maarten, Schepers Tim
Department of Surgery and Traumatology, Reinier de Graaf Groep Delft, Delft, The Netherlands.
J Foot Ankle Surg. 2010 Nov-Dec;49(6):541-5. doi: 10.1053/j.jfas.2010.08.005.
Injuries involving the Chopart joint complex are relatively rare and frequently missed or misdiagnosed, often leading to a poor functional outcome. This study was performed to determine the outcome and morbidity in patients with Chopart joint injuries, and to increase awareness of this severe injury. Patients with a Chopart dislocation or fracture-dislocation, treated between January 2004 and January 2010, were identified using the appropriate diagnosis code and reviewing all radiographs of patients diagnosed with hindfoot or midfoot injuries treated at our institution. Data on patient characteristics, trauma mechanism, delay, and treatment were collected using patient files, operation reports, and by reviewing radiographs. Outcome was determined using the American Orthopaedic Foot & Ankle Society midfoot score and a visual analog scale satisfaction score, in patients with a minimum follow-up of 6 months. Nine patients (1.5 per year) were identified, including 6 women. The mean patient age was 41.6 ± 25.1 years. The trauma mechanism was sprain or sports injury in 5 (55.6%), motor vehicle accident in 3 (33.33%), and a fall from height in 1 (11.11%) case. Seven patients with an average follow-up of 31.3 ± 19.2 months reported a mean American Orthopaedic Foot & Ankle Society midfoot score of 72 (range, 32-100) points and a mean visual analog scale score of 7.1 (range, 5-10). Four (57.14%) patients still experienced pain or had limitations in daily activities at the time of the final follow-up. This study supports the conclusion of previous studies, which stated that a higher level of awareness is needed to prevent permanent disability.
涉及Chopart关节复合体的损伤相对少见，常常被漏诊或误诊，这往往会导致功能预后不良。本研究旨在确定Chopart关节损伤患者的预后及发病率，并提高对这种严重损伤的认识。通过使用适当的诊断编码并查阅我院诊断为后足或中足损伤患者的所有X光片，确定2004年1月至2010年1月期间接受治疗的Chopart脱位或骨折脱位患者。通过患者病历、手术报告以及查阅X光片收集患者特征、创伤机制、延误情况及治疗等方面的数据。对随访至少6个月的患者，使用美国矫形足踝协会中足评分和视觉模拟量表满意度评分来确定预后。共识别出9例患者（每年1.5例），其中6例为女性。患者平均年龄为41.6±25.1岁。创伤机制为扭伤或运动损伤5例（55.6%），机动车事故3例（33.33%），高处坠落1例（11.11%）。7例平均随访31.3±19.2个月的患者，美国矫形足踝协会中足评分平均为72分（范围32 - 100分），视觉模拟量表评分平均为7.1分（范围5 - 10分）。在末次随访时，4例（57.14%）患者仍有疼痛或日常生活受限。本研究支持先前研究的结论，即需要提高认识以预防永久性残疾。
