Abstract
Displacement of the articular facets of talus on the tarsal mechanism, or partial
talotarsal dislocation, is a condition seen in children, adult, and geriatric populations.
A characteristic of this pathologic condition is a prolonged period of and excessive
amount of pronation (hyperpronation) on weightbearing. The ill effects of this condition
may lead to a multitude of other foot pathologies and to pathologies associated with
the proximal lower extremity musculoskeletal structures. A variety of conservative
and operative treatment options have been used to eliminate or minimize hyperpronation.
Extraosseous talotarsal stabilization (EOTTS) devices have been used to realign and
stabilize the articular facets of the talus on the tarsal mechanism, thereby attempting
to restore the normal range of hindfoot motion while eliminating hyperpronation. A multitude
of such devices, which are intended for the same purpose, are available for the surgeon
to choose from. However, there is no literature discussing the differences among these
devices, or the benefits of one device over the other. Based on current understanding
and available knowledge base, the goal of this article was to classify EOTTS devices
based on their design features and biomechanical functioning. A theoretical description
of how these different types of devices function is laid out in an attempt to understand
the reason for their success or failure. This new classification system is intended
to help researchers and surgeons appreciate the subtle yet important differences among
these devices, and to thus help them design future research studies when using these
devices.
Level of Clinical Evidence
Keywords
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Article info
Publication history
Published online: July 16, 2012
Footnotes
Financial Disclosure: This study was funded by Graham International Implant Institute (Macomb, MI).
Conflict of Interest: Michael E. Graham is the inventor of HyProCure. He is the sole owner of GraMedica, LLC, the company that manufacturers and distributes HyProCure.
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Identification
Copyright
© 2012 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Extraosseous Talotarsal StabilizationThe Journal of Foot and Ankle SurgeryVol. 52Issue 5
- PreviewWe appreciated Dr Graham et al's 2 recent articles on arthroereisis [Graham ME, Jawrani NT, Chikka A. Extraosseous talotarsal stabilization using HyProCure® in adults: a 5-year retrospective follow-up. J Foot Ankle Surg 51(1):23–29, 2012; Graham ME, Jawrani NT. Extraosseous talotarsal stabilization devices: a new classification system. J Foot Ankle Surg 51(5):613–619, 2012]. Articles and research are needed to validate collective findings that this is an important procedure for flexible flatfoot and talotarsal dislocation.
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- ReplyThe Journal of Foot and Ankle SurgeryVol. 52Issue 5
