Success in Chopart Amputations

Background: For several decades, the Chopart's amputation has been considered a poor healing amputation due to its high reported failure rate in the literature.

Purpose: The purpose of this study is to evaluate the outcomes of thirty patients from 2013 to 2018 who underwent a Chopart's amputation secondary to infection and/or ischemia.

Methods and Results: Forty four percent of these patients failed to heal, which is consistent with the failure rate reported in the literature. We evaluated patients' BMI, age, severity of diabetes, ambulatory status, revascularization, tendon balancing procedures, and timing of re-ulceration or more proximal amputation to identify factors that have predictive value or influence the success rate.  Reproducible and predictable results of this procedure regarding re-ulceration and/or return to the operating room for further debridement and amputation is invaluable in managing patient expectations, and may redefine what is considered a successful amputation.

Conclusion: This research can help create guidelines and expectations for our patients who are considering this amputation.  Chopart’s amputation can benefit our patients in the right application, and if we determine what influences its success, we may consider the Chopart amputation as a viable option for limb salvage in this high-risk population.