Christopher Honstad1, Edward Fox1 and William Hennrikus2*
1Department of Orthopedics and Rehabilitation, Penn State Hershey Medical Center, USA
2Department of Orthopedics and Rehabilitation, Penn State Hershey Pediatric Bone and Joint Institute, USA
A 9-year-old female presented with non-metastatic Ewing’s sarcoma of the third metatarsal isolated to the forefoot. After neoadjuvant chemotherapy, she underwent a Chopart amputation - a partial amputation of the foot at the level of the transtarsal joint. The Chopart amputation has been shown to have equivalent if not slightly better outcomes than the more common Syme amputation in pediatric patients. However, the Chopart amputation has sometimes been considered less favorable due to the development of equinus deformity. There are specific technical aspects of the procedure that help to minimize development of equinus, including performing tendon transfers of the ankle dorsiflexors to the talar neck through transosseous tunnels in addition to performing a tenotomy of the Achilles tendon. In this article, we discuss the case of a pediatric patient who underwent a Chopart amputation, we compare alternative partial-foot amputation options, and we detail technical pearls to optimize outcomes.
Honstad C, Fox E, Hennrikus W. Chopart Amputation for Ewing’s Sarcoma of the Metatarsal in a Pediatric Patient: Technique and Pearls. Clin Surg. 2019; 4: 2514..