Depends if it’s a recurrent partial talotarsal dislocation or rigiddeformity and also if there are other pathologic osseous alignment issues.
There are 2 Treatment Categories External Internal
Problem with External Options• Cannot stabilize the talus on the tarsal mechanism.• Gives a false sense of correction.• Not corrective, just supportive.• Compliance issues – patient must wear them for them to be effective.
Internal options: depends on thedegree and location of deformities.
A Recurrent Talotarsal Dislocation: Neutral Position Relaxed Stance Position Internal EOTTS Can possibly be internally stabilized via an internal, extra-osseous, extra-articular talotarsal joint stabilizing stent.
Extra-osseous Talotarsal Stabilization (EOTTS) • Stent is made of titanium. • Talus glides over a Type II EOTTS device. • Instantly the joint forces are normalized. • Talotarsal joint is now internally stabilized.
Many times this procedure alone isenough to stabilize the deformity.
Need to evaluate the whole footThis image exhibits a talotarsal joint This image shows a talotarsal jointdislocation with a normal calcaneal dislocation in addition to a lower thaninclination angle. normal calcaneal inclination angle.
Lower than normal Calcaneal Inclination Angle This patient could benefit from the EOTTS device but also requires either a lengthening of the Achilles tendon complex and/or calcaneal osteotomy.
Instability in the Medial Column • If there is significant instability to the mid- foot then additional surgery will be required here. • Many times, this procedure is not performed until the child is older.
Rearfoot reconstructive surgeryis reserved until there is so muchdestruction that there is no other option.
Don’t blow off those misaligned feet as normal!
Children do not out-grow this pathologic deformity.
Where is the evidence that arecurrent talotarsal joint dislocation will heal on its own? There isn’t any, they just get worse!
Not only does this deformity lead to destruction within the foot and ankle,
it leads to a path of destruction up the body.
Benefits of Treatment• Internal option – does not rely on patient compliance• Reversible• Time tested• Scientifically based• Just makes sense
Risks of No TreatmentNot only will this lead to problems within the foot and ankle, it leads to problems in the knees, hips, pelvis, back and neck.
Risks of TreatmentPossible need to remove the stent (EOTTS) Revision Resize – under/over-correction Failure to achieve the desired result There are no complication free procedures
For more information on EOTTS please visit: www.AlignMyFeet.com