Overpronation and Flatfoot : Correction with Subtalar Implants

Overpronation of the feet occurs when the inner arch of the foot drops down and inwards. It is commonly related to excessive tightness of the calf muscles. Severe overpronation oftens results in a Flatfoot deformity.

Due to the abnormal mechanics, pain may result over the medial ankle (Posterior Tibial Tendon hence the other name PTTD or Posterior Tibial Tendon Dysfunction Syndrome), Plantar Fasciitis and Arch pain, as well as possibly leading to Bunion formation.

Overpronation is usually treated non operatively with Orthotics from a Podiatrist. While most men are quite happy to use them, ladies are less keen as they cannot be used with sandals and open footwear.

Failure of treatment with Orthotics previously used to mean complicated foot surgery with long recovery times. Fortunately we now have several minimal access surgical (MAS) options with shorted recovery times. This has revolutionized treatment of mobile flatfeet.

A mobile flat foot is one in which the arch is passively correctable during examination. This accounts for the vast majority of patients with flat feet. The root cause of the foot problem is actually in the tight calf. In many cases there is no abnormality in the foot itself. It is this group of patients who are suitable for these new MAS techniques.

In all these patients, it is essential to examine for the tight calf. In most of these , the tightness must be addressed at surgery as it is the root cause of the problem. Fortunately, it is easily remedied by a MAS technique known as a Gastroc(nemus) Proximal Release.

http://www.livres-medicaux.com/sites-livre/barouk/Site/
http://www.livres-medicaux.com/sites-livre/barouk/Site/Surgical_Treatment_-_P_Barouk.html

This procedure is low risk and the patient can walk immediately after the surgery. No cast is needed. By 5-7 days the patient is more or less walking normally.

The second part of the correction is the use of a Subtalar Stent. This Minimally Invasive Procedure involves the placement of a small Titanium piece of metal that prevents the foot from overpronating. Done one side at a time, the patient can also walk immediately, but will take about 3-4 weeks to be comfortable. Return to running will take about 6-8 weeks.

http://www.hyprocure.com/
https://www.youtube.com/channel/UCW4upNWpNCOO9LvFqQfg-sw

Together, this combination of MAS procedures ie the Gastroc Release and the Subtalar Stent is able to correct many of these patients. Some pateints however, may require additional procedures depending on the severity of the problem.

 bunions2

Falt Foot Before Back

 bunions3

Flatfoot Subtalar After Back

 bunions2

FlatFoot Before Side

 bunions3

Flat Foor After Right