Chopart's fracture

The foot is generally divided into the

• Hindfoot
• Calcaneus
• Talus
• Midfoot
• Cuboid
• Navicular
• Three cuneiforms
• Forefoot
• Metatarsals
• Phalanges
• The articulation between the hindfoot and the midfoot (midtarsal joint) is frequently referred to as Chopart’s joint
• Named after surgeon who performed amputations at the calcaneocuboid, talonavicular joint
• The articulation between the midfoot and the forefoot is referred to as the Lisfranc joint.
  
• Named after French surgeon Francois Chopart (1743–1795) who performed amputations of the foot at this level
• This type of amputation renders the ankle joint unstable as almost all of the points of insertion of the ankle tendons have been remove

• All dislocations of the foot are relatively uncommon with the Lisfranc fracture-dislocation being the most common
• Most are due to falls from a height or motor vehicle accidents
• Males are more likely to have foot dislocations than females
  
• Chopart Fracture

• Chopart fracture-dislocation involves the midtarsal joints (talonavicular and calcaneocuboid joints)
• Typically caused by falls from a height, motor vehicle accidents and severe twisting injuries such as can occur in basketball players who land on a plantar-flexed and inverted foot
• Usually result from severe trauma
• Most commonly, there is medial displacement of the distal fragments (80%)
• The foot is displaced inward and upward
• But displacement in other directions can occur
• Eversion injuries result in lateral dislocations
• There are frequently associated fractures of the calcaneus, cuboid and navicular
• A small percentage are open
• The talus remains in the ankle mortise

Chopart's fracture dislocation. Black arrow points to talus which is dislocated from navicular (yellow
arrow) at talonavicular joint. Calcaneus (blue arrow) is dislocated from the cuboid (red arrow), which is also fractured. The dislocation is at the calcaneocuboid joint. This is an uncommon dislocation.
The forefoot is usually displaced medially rather than laterally as in this case.

• Prognosis

• Prompt reduction and early range of motion generally result in favorable outcome
• High impact injuries with greater soft tissue compromise and associated fractures worsen prognosis

.

Diagram of Chopart's fracture-dislocation from Radiographics.

Carpal tunnel syndrome

This condition was previously most commonly found
in women, 30 to 60 years of age. With the
increasing use of computers, Carpal Tunnel syndrome
is now seen with increasED frequency in all ages,

Phalen's test

Place the backs of both of your hands together and hold the wrists in forced flexion for a full minute. (Stop at once if sharp pain occurs) . If this produces numbness or "pins and needles" along the thumb side half of the hand, you most likely have Median nerve entrapment (Carpal Tunnel Syndrome). Examination by a health care professional familiar with these conditions is the way to be sure of the diagnosis and get proper treatment.

Hammer toes

Hammer toes come in all shapes and sizes. Hammer toes can be found to affect one of the toes or all of the toes simultaneously. The name, hammer toe comes from the way the toe hits or hammers on the floor with each step. The primary deformity seen in a hammer toe is found at the PIPJ (proximal interphalangeal joint) which is the first or more proximal of the two joints of the toe. A

Bohler's angle ( Tuber joint angle )

 

-Bohler's angle also called as the Tuber joint angle, measures the angular relationship between talus and calcaneum. This angle is formed by two lines . first line is drawn from the posteriosuperior margin of the calcaneal tuberosity through the tip of the posterior facet of the subtalar joint. second line is drawn from the tip of the posterior facet through the superior margin of the anterior process of the calcaneum.

-Normally this angle ranges between 20 and 40 degrees.

-Flattening of this angle is a classic x-ray sign of depressed fracture of calcaneum. 

P.S : The image is not my original work and has been taken from the wikimedia commons project and the author is Gilo1969.