Achieving functional ambulation in a patient with Chopart amputation.

Abstract

Chopart amputation provides an interesting functional dilemma for the patient, physiatrist, and prosthetist. This problem is further complicated when the patient develops an equinus contracture from an unbalanced short forefoot lever. Also, genu recurvatum occurs as a consequence of recurrent knee hyperextension from this contracture. There are few reports on the most functional prostheses for this type of patient. We present a case of a pediatric patient with a Chopart amputation who demonstrated genu recurvatum during ambulation. After experimenting with many different types of prostheses, he had persistent lower-limb pain. We prescribed a Chopart prosthesis with a flexible inner socket and a carbon fiber energy-storing keel with posterior calf struts. At his follow-up clinic visit, he no longer had pain, and he was able to play soccer. This device provides a functional alternative for those patients with Chopart amputation who are unable to participate in athletic activities.