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Extra-Osseous TaloTarsal Stabilization Treatment Guide


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The partial dislocation of the ankle bone on the heel bone leads to destructive forces that act on our feet, knees, hips and back. This presentation discusses the insertion of a stent into a naturally open space that instantly stabilizes the ankle bone while allow, as close as possible, the natural motion to occur.

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Extra-Osseous TaloTarsal Stabilization Treatment Guide

  1. 1. Extra-Osseous TaloTarsal Stabilization(EOTTS)Your Guide to Treatment
  2. 2. EOTTS• Extra-Osseous (outside thebone)• Restores normal amount ofmotion• Prevents excessive motionbetween two or more bones• Is different from Interosseousor Intraosseous stabilization.
  3. 3. HyProCure® Solution• Internal• Extra-osseous• Extra-articular• Bone stabilizationdevice.
  4. 4. TalusCalcaneusTaloTarsal MechanismTalus acting on thearticulations with thecalcaneus and navicular
  5. 5. Normal Talotarsal Alignment
  6. 6. Normal to abnormal alignmentmisalignment of the talus on the tarsal mechanism
  7. 7. Normal to abnormal alignmenttalus drops forward and down
  8. 8. Normal to abnormal alignmentsinus tarsi partially collapses
  9. 9. Normal to abnormal alignmentNavicular drops leading to lowering of the arch of thefoot
  10. 10. This is NOT normal. Its not that the “arch” gave way and the talushas fallen out of position. The talus is partially dislocated off thetalotarsal articulations and that is what leads to the lowering ofthe arch. If the talus is repositioned than the navicular bone willraise indicating normalization of the arch of the foot.
  11. 11. Abnormal Talotarsal Alignment
  12. 12. Normal to abnormal alignmentthe talus is repositioned on the tarsal mechanism and there isrealignment of the osseous structures.
  13. 13. Normal and Abnormal TaloCalcanealArticulationsNormal Abnormal
  14. 14. The articulations of thetalus on thetarsal mechanismWith the TTM inSUPINATED POSITION
  15. 15. The articulations of thetalus on thetarsal mechanismWith the TTM inNEUTRAL POSITION
  16. 16. The articulations of thetalus on thetarsal mechanismWith the TTM inPRONATED POSITION
  17. 17. The articulations of thetalus on thetarsal mechanismWith the TTM inDislocation-Partial of the
  18. 18. This is a dynamic deformity.With every step takenexcessive abnormal forces are acting on thejoints, ligaments, muscles, tendons, & neurovascularstructures
  19. 19. TaloTarsalDislocationSyndromeAs a result of the excessive abnormal forces actingon the structures of the foot and ankle combinedwith the fact the average person takes 6,000 to10,000 steps a day. Something will eventuallybecome damaged.
  20. 20. TaloTarsal Dislocation Syndrome (TTDS)• Symptoms from thisdeformity will presentat the weakest link inthe chain.• Are we covering up thesymptom or curing theunderlying problem?
  21. 21. Symptoms of TTDS in the foot• Bunions• Hammertoes• Heel Pain/Plantar fasciopathy• Tarsal Tunnel Syndrome• Posterior tibial tendon dysfunction• Abnormal gait pattern• Shin splints• Abnormal shoe wear• Growing pains
  22. 22. Effect of TTDS on the body• The body of the talus islocked into the ankle joint.• When the talus slips off thetarsal mechanism thatimmediately forces theankle joint to turn inwardand downward.
  23. 23. This translates to excessivemotion that can potentiallyaffect theneckspinepelvishipskneefar more than just the foot.
  24. 24. TREATMENTWhat is the best way to fix thispathologic deformity?
  25. 25. How can something located on the bottomof the foot/tarsal mechanismcontrol/stabilize something above it?Does it make sense to you?
  26. 26. HyProCure-Extra Osseous Talotarsal Extra-ArticularInternal Stabilization Device
  27. 27. HyProCure®internallystabilizes thetalus toprevent thedislocation.
  28. 28. HyProCureallows thenormal amountof motion tooccur.
  29. 29. Before
  30. 30.
  31. 31. Before
  32. 32.
  33. 33. HyProCure®Internal permanent solutionnot dependent on
  34. 34. Before/After
  35. 35. 2 Weeks Post-OpThe Knees
  36. 36. If we stabilize the TTM than we can alsohelp the rest of the
  37. 37. Physician’s Treatment GoalsEarly ambulationEffective correctionLeast amount of down timeLeast amount of complicationsReturn to normal functionDo no harmWhy wait until major rearfootreconstructive surgery is the onlyoption?
  38. 38. “Changing Lives, One Step at a Time”