Case for small group discussion Midfoot injury Case for small group discussion AOTrauma—Foot & Ankle Module 4b: Midfoot trauma—Chopart, navicular fractures Michael Swords, US
Case description 16-year-old man Foot injured in farm equipment Otherwise healthy
Open wound
Initial treatment options?
Emergency management External fixator, irrigation, and debridement
CT scan—loss of anterior process
External fixation Bicolumnar external fixator to restore column length with antibiotic spacer to fill bone void
Postoperative x-rays Delayed calcaneocuboid arthrodesis with reamer/irrigator/aspirator (RIA) system from ipsilateral femur
2-year follow-up
Take-home messages Restore column length with external fixation Delayed bone graft due to open injury Stable fixation