Extra-Ossoues TaloTarsal Stabilization Leads to Normalized Navicular Position.


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Partial talotarsal dislocation may lead to a drop in the height of the navicular bone. This leads to a loss of arch height, more commonly known as fallen arches. This could be considered a cosmetic concern but more importantly it is a structural deformity that leads to increased strain on the support structures of the medial column of the foot.

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Extra-Ossoues TaloTarsal Stabilization Leads to Normalized Navicular Position.

  1. 1. Radiographic Evaluation of Navicular Position in the Sagittal Plane –Correction Following an Extra-Osseous TaloTarsal Stabilization Procedure Journal of Foot and Ankle Surgery, Volume 50, Issue 5 Pages 551-557, September 2011 Michael E. Graham, DPM, FACFAS, Nikhil T. Jawrani, MS, Avanthi Chikka, MSPurpose Lateral Weightbearing Radiographs:The focus of this study was to radiographically TaloTarsal Mechanismdetermine the effect of the HyProCure® extra-osseous talotarsal fixation device on navicularposition. It was hypothesized that weightbearingnavicular height would increase significantlyfollowing the placement of HyProCure® comparedto the preoperative values due to stabilization oftalotarsal dislocation. (A): Normal TTM (B): Abnormal TTM (C): w/HyProCure®Background ResultsAnteriomedial talar dislocation (partial) on the  The mean preoperative true navicular to cuboidtarsal mechanism during weightbearing places distance was 19 ± 6 mm as compared to a meanexcessive force anteriomedially. As a result of the postoperative value of 24 ± 5 mm.excessive, abnormal force, the navicular maycompensate by “dropping”. Navicular drop leads to  The mean pre- and postoperative normalizeda loss of arch height and signifies a pathologic force navicular to cuboid distances were 0.098 ± 0.029acting on the medial column of the foot as well as and 0.125 ± 0.027, respectively (± 1 SD).its associated supporting structures such as the  The postoperative increase in the true andposterior tibial tendon, spring ligament, and the normalized navicular to cuboid distance wasmedial band of the plantar fascia. External measures statistically significant (p < .001).have significant limitations in regards tomaintaining navicular height. Clinical Significance & Conclusions  Not all patients with anteriomedial dislocationMethods (partial) of the talus on the calcaneus exhibited Radiographs were analyzed of 61 adult patients navicular drop. (86 feet) who underwent talotarsal fixation with  However, every patient with navicular drop HyProCure® without adjunctive hindfoot or exhibited anteriomedial dislocation of the talus midfoot soft tissue or osseous procedures. on the calcaneus. The distance of the navicular with respect to the  Navicular height significantly increased by an cuboid was measured on the pre- and average of 26% following hindfoot stabilization postoperative weightbearing lateral radiographs. with HyProCure®. Foot length was factored to normalize the  HyProCure® was effective in improving the navicular to cuboid distance. anatomic alignment of the talonavicular joint. Postoperative radiographs were taken at an  This should lead to a decrease in force placed on average follow-up of 17 days. the medial column of the foot and therefore a decreae in strain on the supporting structures. Talotarsal joint stabilization with HyProCure® lead to an average 26% increase in navicular height. Additional Scientific Papers on HyProCure® are available. Visit the Library section on: www.GraMedica.com