Abstract
The navicular drop in the sagittal plane on weight-bearing is a valid indicator of
foot pronation. Dislocation of the talus on the tarsal mechanism results in hyperpronation,
which can lead to excessive navicular drop. The purpose of the present study was to
radiographically determine the efficacy of HyProCure® in realigning the navicular bone in hyperpronating feet. We hypothesized that following
the placement of HyProCure®, the navicular height would increase significantly compared to its preoperative value.
Radiographs of 61 adult patients (86 feet) who received HyProCure® without adjunctive hindfoot or midfoot soft tissue or osseous procedures were analyzed.
The distance of the navicular with respect to the cuboid was measured from the pre-
and postoperative weight-bearing lateral radiographs. Additionally, we measured foot
length to normalize the navicular to cuboid distance. The postoperative radiographs
were taken at an average follow-up of 17 days. The mean preoperative true navicular
to cuboid distance was 19 ± 6 mm as compared to a mean postoperative value of 24 ±
5 mm. The mean pre- and postoperative normalized navicular to cuboid distances were
0.098 ± 0.029 and 0.125 ± 0.027, respectively (± 1 SD). The postoperative increase
in the true and normalized navicular to cuboid distance was statistically significant
(p < .001). HyProCure® was effective in improving the anatomic alignment of the talonavicular joint by reducing
excessive navicular drop. This indicates reduction of excessive abnormal pronation
and stabilization of the medial column of the foot, which can also lead to reduction
in the excessive forces placed on the supporting soft tissue structures.
Level of Clinical Evidence
Keywords
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Article info
Publication history
Published online: June 17, 2011
Footnotes
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.
Identification
Copyright
© 2011 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.
