Chopart's sprain and osteopathy
Chopart's sprain is an injury to the Chopart's joint complex in the foot, often underestimated and misdiagnosed. Studies show that Chopart's complex injuries are relatively rare, but have a high misdiagnosis rate of between 20% and 41%. Proper diagnosis and treatment of these lesions are essential to avoid long-term complications, such as chronic pain, swelling, instability and potentially post-traumatic flatfoot deformity.
What is chopart's sprain?
Chopart's sprain refers to an injury to the Chopart's joint in the foot.
A Chopart's sprain occurs when the ligaments holding this joint are stretched or torn, often as a result of trauma such as twisting or direct impact on the foot.
The chopart joint
The Chopart's joint, also known as the medio-tarsal joint complex, is a crucial anatomical structure in the foot. It plays a fundamental role in foot biomechanics and locomotion. Understanding its function and importance is essential for health professionals, athletes and anyone interested in foot medicine.
The Chopart joint is composed of two distinct articulations:
- Talonavicular joint: connects the talus to the navicular bone.
- Calcaneocuboid joint: links the calcaneus to the cuboid.
This joint forms a dividing line between the posterior and anterior tarsus of the foot, enabling complex movements and providing both stability and flexibility.
The Chopart joint is involved in several essential movements of the foot:
- Inversion and Eversion: These movements enable the foot to adapt to uneven surfaces and play a role in balance.
- Flexion and extension: These actions are crucial for walking, running and jumping.
These movements are regulated by various ligaments and muscles, which work together to maintain joint integrity and prevent injury.
Mechanism of onset:
This injury can occur in a number of ways, usually as a result of trauma or excessive force applied to the foot. Here are some common scenarios that can lead to a Chopart's sprain:
- High-energy trauma :
- Road accidents: Vehicle collisions, particularly motorcycle accidents, can exert significant force on the foot, causing sprains.
- Falls: Falls from height, where the foot lands abnormally or at an angle, can cause a Chopart's sprain.
- Sports activities :
- Sports with jumps and landings: Sports involving jumps, such as basketball or gymnastics, can cause this injury with poorly executed landings.
- Contact sports: Sports activities involving collisions or sudden movements, such as soccer or rugby, can lead to Chopart's sprains.
- Torsional or rotational movements :
- Unexpected movements: Sudden or unexpected movements of the foot, such as slipping or stumbling, can cause abnormal twisting, leading to a sprain.
- Direct Impact on the Foot:
- Direct blows: A direct impact on the foot, such as a heavy object falling on the foot, can damage the ligaments of the Chopart's joint.
- Overuse or repetitive movements: Although less common, repetitive stress on the Chopart's joint can also contribute to a sprain, particularly in athletes.
It's important to note that Chopart's sprain can often be overlooked or misdiagnosed due to its rarity and subtle symptoms. People experiencing pain or instability in the foot after trauma should consult a professional for proper diagnosis and treatment.
Diagnosis of Chopart's sprain
Diagnosis of Chopart's sprain relies mainly on a precise clinical examination, requiring a good knowledge of foot anatomy. Radiographic signs of this injury may be indirect and often discrete, mainly comprising bone pull-outs or impaction lesions.
Ultrasound can already reveal bone loss. It may be useful to supplement this examination with an X-ray or CT scan. Magnetic resonance imaging (MRI) may be necessary for a precise assessment of the soft tissues.
Treatment of Chopart's sprain
What to do immediately in the event of a chopart sprain?
When you suspect a Chopart's sprain, it's important to react quickly to minimize damage and speed healing. Here are the initial steps to take:
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Rest: Stop all activity and avoid putting weight on the injured foot. Immediate rest is crucial to avoid aggravating the injury.
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Ice: Only apply ice to the injured area for 12 minutes within the first few hours of injury, to prevent excessive bleeding. However, the use of ice for 15 minutes several times a day is no longer recommended. This is because ice stops the body's normal inflammatory reaction, which allows healers to be brought to the area. Inflammation is therefore a normal process that the body puts in place to heal. Icing relieves pain but slows down the healing process. Use an ice pack or cold pack, wrapped in a cloth to prevent cold burns.
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Do not use anti-inflammatories : for the same reasons as for ice, it is not advisable to use anti-inflammatories. What's more, anti-inflammatories have deleterious effects on all tissues, including bone, tendons, muscles and ligaments.
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Compression: Use strapping to immobilize the area. Be careful not to wrap the area too tightly, as this could impede blood circulation.
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Elevation: Keep the injured foot elevated above heart level. This helps reduce swelling and pain.
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Consultation: Consult a professional as soon as possible for an accurate diagnosis. Chopart's sprains can be difficult to diagnose, and a thorough clinical examination, potentially supplemented by imaging such as X-rays, is necessary to rule out other injuries such as bone pulls or fractures.
Non-surgical treatment of Chopart's sprain is mainly functional, including rest, immobilization with a walking boot and physiotherapy.
Surgical treatment is considered exceptional.
Osteopathy and chopart's sprain
Osteopathic treatment of a Chopart's sprain may involve manual techniques to improve joint mobility and reduce pain. The osteopath may use gentle manipulation to realign the bones of the foot and massage techniques to reduce inflammation and improve circulation in the injured area.
The role of osteopathy is to focus on realigning the structures of the foot and correcting musculoskeletal imbalances. An osteopath will use specific adjustments to restore normal joint function and manual therapy techniques to relieve pain and inflammation.
In the case of bone tears, it is essential to wait a few weeks to months before considering osteopathic manipulation. Your osteopath will be able to advise you and will practice only after a good questioning and a thorough clinical examination.
The osteopathic treatment plan is personalized and tailored to the severity of the sprain and the patient's specific symptoms.
The osteopath will advise the patient on exercises to strengthen the foot muscles and improve stability.
In conclusion on chopart's sprain
Chopart's sprain is a complex injury requiring careful attention to diagnosis and an individualized approach to treatment. Appropriate management is crucial to avoid long-term complications and ensure optimal recovery of foot function.
Marie Messager
Osteopath D.O
2 rue Alexis de Tocqueville
78000 Versailles
