Limb salvage with Chopart's amputation and tendon balancing

For several decades, Chopart's amputation has met with some skepticism owin g to reports of significant equinus deformity developing soon after the pro cedure is performed. However, with appropriate tendon balancing, which gene rally includes anterior tibial tendon transfer and tendo Achillis lengtheni ng, this level of amputation is often more functional than slightly more di stal amputations, such as Lisfranc or short transmetatarsal amputations. Th e authors offer a rationale for this observation, which includes a discussi on of the longitudinal and transverse arch concept of the foot. This concep t dictates that the shorter the midfoot-level amputation, the more likely t he patient is to develop an equinovarus deformity, thus exposing the fifth metatarsal base and cuboid to weightbearing stress and a high risk of ulcer ation. Chopart's amputation, in eliminating the cuboid, often obviates the potential varus deformity and thus can have a more acceptable long-term res ult.