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.

1. Extra-Osseous TaloTarsal Stabilization
(EOTTS)
Your Guide to Treatment

2. EOTTS
• Extra-Osseous (outside the
bone)
• Restores normal amount of
motion
• Prevents excessive motion
between two or more bones
• Is different from Interosseous
or Intraosseous stabilization.

3. HyProCure® Solution
• Internal
• Extra-osseous
• Extra-articular
• Bone stabilization
device.

4. Talus
Calcaneus
TaloTarsal Mechanism
Talus acting on the
articulations with the
calcaneus and navicular

5. Normal Talotarsal Alignment

6. Normal to abnormal alignment
misalignment of the talus on the tarsal mechanism

7. Normal to abnormal alignment
talus drops forward and down

8. Normal to abnormal alignment
sinus tarsi partially collapses

9. Normal to abnormal alignment
Navicular drops leading to lowering of the arch of the
foot

10. This is NOT normal. Its not that the “arch” gave way and the talus
has fallen out of position. The talus is partially dislocated off the
talotarsal articulations and that is what leads to the lowering of
the arch. If the talus is repositioned than the navicular bone will
raise indicating normalization of the arch of the foot.

11. Abnormal Talotarsal Alignment

12. Normal to abnormal alignment
the talus is repositioned on the tarsal mechanism and there is
realignment of the osseous structures.

13. Normal and Abnormal TaloCalcaneal
Articulations
Normal Abnormal

14. The articulations of the
talus on the
tarsal mechanism
With the TTM in
SUPINATED POSITION

15. The articulations of the
talus on the
tarsal mechanism
With the TTM in
NEUTRAL POSITION

16. The articulations of the
talus on the
tarsal mechanism
With the TTM in
PRONATED POSITION

17. The articulations of the
talus on the
tarsal mechanism
With the TTM in
Dislocation-Partial of the TTM
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18. This is a dynamic deformity.
With every step taken
excessive abnormal forces are acting on the
joints, ligaments, muscles, tendons, & neurovascular
structures

19. TaloTarsal
Dislocation
Syndrome
As a result of the excessive abnormal forces acting
on the structures of the foot and ankle combined
with the fact the average person takes 6,000 to
10,000 steps a day. Something will eventually
become damaged.

20. TaloTarsal Dislocation Syndrome (TTDS)
• Symptoms from this
deformity will present
at the weakest link in
the chain.
• Are we covering up the
symptom or curing the
underlying problem?

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. Effect of TTDS on the body
• The body of the talus is
locked into the ankle joint.
• When the talus slips off the
tarsal mechanism that
immediately forces the
ankle joint to turn inward
and downward.

23. This translates to excessive
motion that can potentially
affect the
neck
spine
pelvis
hips
knee
far more than just the foot.

24. TREATMENT
What is the best way to fix this
pathologic deformity?

25. How can something located on the bottom
of the foot/tarsal mechanism
control/stabilize something above it?
Does it make sense to you?

26. HyProCure-
Extra Osseous Talotarsal Extra-Articular
Internal Stabilization Device

27. HyProCure®
internally
stabilizes the
talus to
prevent the
dislocation.

28. HyProCure
allows the
normal amount
of motion to
occur.

29. Before

30. HyProCured
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31. Before

32. HyProCured
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33. HyProCure®
Internal permanent solution
not dependent on shoe-gear.
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34. Before/After

35. 2 Weeks Post-Op
The Knees

36. If we stabilize the TTM than we can also
help the rest of the body.
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37. Physician’s Treatment Goals
Early ambulation
Effective correction
Least amount of down time
Least amount of complications
Return to normal function
Do no harm
Why wait until major rearfoot
reconstructive surgery is the only
option?

38. “Changing Lives, One Step at a Time”