Abstract
Tarsal tunnel syndrome is characterized by increased pressure in the tarsal tunnel.
In hyperpronation, there is excessive abnormal pronation resulting from partial displacement
of the talus on the calcaneus. In this study, we hypothesized that hyperpronation
caused by talotarsal instability will lead to increased pressure in the tarsal tunnel
and porta pedis. We also hypothesized that the pressure in these compartments will
decrease following an extra-osseous talotarsal stabilization procedure using HyProCure®. Pressures in the tarsal tunnel and porta pedis were measured in 9 fresh-frozen cadaver
specimens using an intracompartmental pressure monitor system. Pressures were measured
with the foot in neutral and hyperpronated position, before and after stabilization
using HyProCure. For the tarsal tunnel, pressure in the neutral position with and
without HyProCure was 3 ± 3 mm Hg and 4 ± 3 mm Hg, respectively (P = .159). However, for the hyperpronating foot, the pressure decreased from 32 ± 16
mm Hg to 21 ± 10 mm Hg (P < .001) following the placement of HyProCure. In the porta pedis, pressure in the
neutral position with and without HyProCure was 2 ± 2 mm Hg and 2 ± 2 mm Hg, respectively
(P = .168). However, for the hyperpronating foot, the pressure decreased from 29 ± 15
mm Hg to 18 ± 11 mm Hg (P < .001) following the placement of HyProCure. The pain caused by compression of the
posterior tibial nerve in the tarsal tunnel and its branches in the porta pedis, owing
to hyperpronation, may be alleviated by implantation of HyProCure.
Level of Clinical Evidence
Keywords
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Article info
Publication history
Published online: November 25, 2010
Footnotes
Conflict of Interest: Dr. Michael E. Graham is the inventor of HyProCure® Sinus Tarsi Stent. He is also the Owner & Founder of GraMedica, LLC and Graham International Implant Institute.
Financial Disclosure: None reported.
Identification
Copyright
© 2011 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.
