Original ResearchRadiographic Evaluation of Navicular Position in the Sagittal Plane—Correction Following an Extraosseous Talotarsal Stabilization Procedure
Section snippets
Patients and Methods
According to the patient history and preoperative clinical and radiographic evaluation, the patients who were diagnosed with talotarsal dislocation were considered suitable candidates for an extraosseous talotarsal stabilization procedure using HyProCure®. The clinical signs and/or symptoms relating to talotarsal dislocation presented by these patients before surgery were 1 or more of the following: excessive pain in the medial column of the foot, hyperpronation, collapse of the medial
Results
A total of 83 patients (34 men and 49 women) with 117 operated feet (34 patients with bilateral and 49 patients with unilateral procedures) responded for participation in this cohort study. The mean age at the time of surgery for this group was 58 (range 22 to 85) years. The radiographically measured pre- and postoperative values of the true navicular to cuboid distance, truncated foot length, and normalized navicular to cuboid distance are shown in Table 1. The mean preoperative true navicular
Discussion
Instability of the TTM leading to hyperpronation is one of the most common underlying etiologies of foot and ankle pathologies. The relationship between hyperpronation and pathologies of the lower extremity has been widely reported and considered valid 3, 24. Hyperpronation is associated with conditions such as posterior tibial tendon dysfunction, plantar fasciopathy, Achilles tendinitis, tarsal tunnel syndrome, first ray disorders, hallux abductovalgus, anterior cruciate ligament injury, and
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Comparison of Extraosseous Talotarsal Stabilization Implants in a Stage II Adult-Acquired Flatfoot Model: A Finite Element Analysis
2017, Journal of Foot and Ankle SurgeryCitation Excerpt :The type II implant is more effective than the type IB implant because it more closely resembles the tarsal sinus shape, allowing it to function more physiologically. Graham et al (6–11) conducted a series of biomechanics studies on the type II sinus tarsi implant. They concluded that the type II implant not only can relieve the strain on the posterior tibial tendon, posterior tibial nerve, and plantar fascia, but can also restore the arch height and correct the flatfoot deformity to a significant extent.
Dynamic in-vivo assessment of navicular drop while running in barefoot, minimalist, and motion control footwear conditions
2015, Gait and PostureCitation Excerpt :An alternative approach for assessing pronation is to quantify ND, i.e., the change in vertical position of the navicular tuberosity. The original description of this technique involved measuring ND with a ruler [12], but since then ND has been measured using a coordinate measuring machine [13], optical motion capture systems (e.g., [14]), single-plane fluoroscopy [15], and a wearable in-shoe sensor [16]. Similar to measures of rearfoot motion, ND has often been quantified using skin- or shoe-mounted markers that are susceptible to errors due to marker motion relative to the underlying bone.
Congenital Talotarsal Joint Displacement and Pes Planovalgus. Evaluation, Conservative Management, and Surgical Management.
2013, Clinics in Podiatric Medicine and SurgeryCitation Excerpt :There is a preponderance of evidence showing the benefit of an EOTTS procedure to decrease strain to the medial band of the plantar fascia, posterior tibial tendon, and tibial posterior nerve, and to decrease pressures within both the tarsal tunnel and porta pedis.8,9,26,27 Radiographically, EOTTS has been shown to reduce the amount of sagittal plane sag of the navicular28 and correct both transverse and sagittal plane talotarsal deformities (Fig. 6).29 A limitation of EOTTS is that it has not been shown to have an effect on the calcaneal inclination angle, either positively or negatively.
Extraosseous Talotarsal Stabilization Using HyProCure<sup>®</sup>: Preliminary Clinical Outcomes of a Prospective Case Series
2013, Journal of Foot and Ankle SurgeryExtraosseous Talotarsal Stabilization Devices: A New Classification System
2012, Journal of Foot and Ankle SurgeryCitation Excerpt :Unlike the type I laterally anchored devices that function as a talar door stop, the type II device functions like a stent placed within an artery to keep it open. The anterior-lateral portion of the talus, distal to the posterior articular talocalcaneal facet, is in contact with the tapered conical portion of the type II device, which transforms the “negative” space into a “positive” space (6,32,34). Another way to look at the function is that the plantar aspect of the talus is reconfigured with the placement of such a device; instead of having an open void there is a solid extension resurfacing that fits anatomically within the calcaneal fossa.
Financial Disclosure: GraMedica, LLC (Macomb, MI) funded the research for the present study.
Conflict of Interest: Michael E. Graham is the inventor of HyProCure® and the sole owner of GraMedica, LLC, which manufacturers and distributes HyProCure® nationally and internationally. He lectures on an on-going basis about HyProCure® to foot surgeons worldwide.