François Chopart
François Chopart (1743 – 1795) was a French Surgeon.
Chopart was a pioneer of urological surgery and is often referred to as the ‘father of urology‘. Born in 1743, his parents owned a haberdashery in Paris and made the greatest efforts to provide him with a good education. He excelled in grammar school and chose to pursue a career in surgery, enrolling at the Hotel-Dieu school of medicine in Paris. He maintained a strong educational aspect throughout his career, and was known for having friendly and collegial relationships with his students.
In 1780 he published a two volume work named Traité des Maladies chirurgicales et des operations qui leur convenient with his contemporary Desalt, with whom he had developed a close relationship. In the preface, they dedicated the treatise to their students of surgery, stating that it contained the first principles of the art of healing. In 1791 he published the two-volume classic – Traité Des Maladies Des Voies Urinaires.
He lived the celibate life, and in 1795 passed away after suffering from thirty-six hours of abdominal pains. On autopsy he was found to have an intestinal volvulus.
The mid-tarsal joint is named the Chopart joint – Chopart disarticulated this joint when performing forefoot amputations (Chopart amputation). A Chopart fracture-dislocation involves a midtarsal joint (talonavicular and calcaneocuboid) dislocation with associated fractures
Biography
- Born on October 30, 1743 in Paris. Used his father’s first name with the maiden name of his mother
- 1761 – Master of Arts at College Mazarin
- Surgical studies under Maître Moreau at Hôtel-Dieu Hospital, Paris
- Surgical studies under Maître Coutavoz at Hospice de la Pitié, Paris
- Surgical studies at Hôpital Bicêtre, Paris
- 1770 – Maître en Chirurgie
- 1778 – Master of Surgery degree with great distinction, writing his thesis in Latin on “Injuries of the Head”‘
- 1779 – Published with Pierre-Joseph Desault surgical lecture notes “Traité des maladies chirurgicales, et des opérations qui leur conviennent” (Treaty of Surgical Diseases and Operations)
- 1782 – Professor of physiology at the College de Chirurgie de Paris
- 1791 – Published ground-breaking 2-volume urological classic – Traité des maladies des voies urinaires
- 1790 – Director Hospice des Ecoles de Chirurgie founded by King Louis XVI
- Died on June 9, 1795
Pour tout dire en un mot, Chopart a emporté avec lui la récompense du sage j celle d’avoir pu dire en terminant sa carrière: «Je n^ai fait que du bien sur la terre, et nul ne pourra s’élever contre ma mémoire.
Pierre Sue, 1812
Medical Eponyms
Chopart joint – Articular space between the hindfoot and the midfoot, was described by Chopart as a practical space for amputations in cases of distal foot necrosis (AKA: Articulatio tarsi transversa, midtarsal joint, transverse tarsal articulation.)
Chopart amputation – amputation through the midtarsal (Chopart) joint. The calcaneus, talus, and other parts of the tarsus are retained, and the soft parts of the sole of the foot cover the stump. An effective procedure for patients allowing weight bearing and associated with reduced infection over other lower extremity amputations.
Chopart fracture dislocation A dislocation of the foot through the talonavicular and the calcaneocuboid joints (Chopart joint) with associated fractures
1792 – Lafiteau who provided the first description of Chopart’s method of partial amputation of the foot and Chopart’s joint in Volume IV of Fourcroy ‘La médecine éclairée par les sciences physiques‘ in 1792. [Volume IV: 85-86; 87-88]. The fracture-dislocation was attributed at a later date.
Charles Saujout, âgé de vingt-six ans, cuisinier, fut attaqué en 1787 d’un petit ulcère à la partie supérieure du gros orteil du pied gauche (…) il survint un engorgement inflammatoire qui s’étendit au loin sur la partie supérieure du pied (…)
La nature carcinomateuse de cette tumeur ne laissoit d’autre resource que l’amputation de la partie malade: mais comme la portion du pied voisine de son articulation avec la jambe étoit parfaitement saine, M. Chopart jugea qu’il étoit possible de la conserver en amputant dans l’articulation de l’astragale avec le scaphoïde, et dans celle du calcaneum avec le cuboïde.
Le 21 août, il fit d’abord deux incisions latérales, l’une au côté interne et l’autre au côté externe du pied (…) ensuite il fit une section transversale qui joignait l’extrémité antérieure des deux premières incisions: le lambeau formé par ces trois incisions ayant été disséqué jusqu’à sa base, M. Chopart coupa en travers les tendons des muscles extenseurs des orteils, le muscle pédieux et les ligamens tant supérieurs que latéraux qui unissent l’astragale au scaphoïde et la calcaneum au cuboide; ensuite il luxa ces os en abaissant la pointe du pied, ce qui lui donna la facilité de porter son bistouri entre les os et le parties molles de la plante du pied qu’il coupa de derrière en devant de manière à former un lambeau inférieur un peu plus long que le supérieur.
Charles Saujout, aged 26 years, chef, suffered in 1787 a small ulcer on the top of his big toe on the left foot (…) an inflammatory engorgement ensued, which extended far up onto the superior aspect of the foot (…)
The carcinomatous nature of this tumour left no other option, but to amputate the diseased part: but since the portion of the foot next to the articulation with the leg was perfectly healthy, Mr. Chopart judged that it would be possible to conserve the former by amputating in the articulation of the talus with the navicular, and of the calcaneus with the cuboid.
On the 21st of August, he first made two lateral incisions, one on the internal, one on the external side of the foot (…) he then made a transverse incision joining the anterior extremities of the two first incisions: having dissected the flap formed by these incisions down to it’s base, Mr. Chopart transected the tendons of the extensor muscles of the toes, and the superior and lateral ligaments which bind the talus to the navicular, and the calcaneus to the cuboid; he then luxated these bones by lowering the tip of the foot, allowing him to bring his scalpel between the bones and the soft tissue of the sole of the foot, which he cut from back to front, such as to form an inferior flap slightly longer than the superior one.
Like Lisfranc (with the tarsometatarsal joint), Chopart had his procedure of midtarsal joint and the attributed fracture-dislocation injury eponymously attributed to him.
La gloire de remettre en usage l’ablation partielle du pied dans les articulations astragalo-scaphoïdienne et calcanéo-cuboïdienne, était réservée à Chopart; d’ailleurs, les détails opératoires donnés avant lui se réduisent à rien, ou sont trop cruels pour être praticables.
The fame of reíntroducing the partial ablation of the foot in the talo-navicular and calcaneo-cuboid articulations, is attributed to Chopart; in any case, the operation reports recorded before him amount to nothing, or are too cruel to be practicable.
Controversies
Astley Paston Cooper visited Paris June 1792 to attend lectures and surgery of Desault and Chopart. Cooper recorded that whilst watching Chopart operate on 10 September 1792…he heard the first cannon fired as the French revolution began!
Major Publications
- Chopart F. Desault, PJ. Traité des maladies chirurgicales, et des opérations qui leur conviennent. and Volume II 1779
- Chopart F. Traité Des Maladies Des Voies Urinaires (Treatise on urinary tract diseases) 1791
- Soupé EF Chopart F. De paraphimosi: positiones anatomicae et chirurgicae. 1793
References
Biography
- Sue P. Notice historique sur François Chopart. Journal de médecine, de chirurgie et de pharmacologie 1812; 25: 349-363.
- Leonardo RA. Lives of Master Surgeons, New York, 1948: 101-103
- Bibliography. Chopart, François 1743-1795. WorldCat Identities
- Prada A. François Chopart. 2020
Historical reference
- Lafiteau. ‘Observation sur une amputation partielle du pied.’ In: Antoine François Fourcroy. La médecine éclairée par les sciences physiques, ou Journal des découvertes relatives aux différentes parties de l’art de guéri. Paris, chez Buisoon, 1792. Volume IV p85-88.
- Garrè C, Borchard A. Amputation und Exartikulationen. Lehrbuch der Chirurgie, 1922: 693-695
- Wolf, J.H. Francois Chopart (1743-1795) – inventor of the partial foot amputation at the transtarsal articulation. Operat Orthop Traumatol. 2000; 4: 314–317.
- Cadogan M. Eponymous foot injuries. LITFL 2021
Resident medical officer in emergency medicine MB ChB (Uni. Dundee) MRCS Ed. Avid traveller, yoga teacher, polylinguist with a passion for discovering cultures.