HyProCure is an internal talotarsal stabilization device. It offers internal correction for an internal deformity. It is indicated in pediatric, adult and geriatric patients with flexible talotarsal dislocation.

1. HyProCure®Extra-Osseous TaloTarsal Stabilization Before & After

2. www.HyProCure.com “Simplicity is achieving maximum results with minimal effort”

3. What exactly can be achieved with HyProCure®? www.HyProCure.com

4. HyProCure®is a very valuable effective tool. Let’s take a closer look. www.HyProCure.com

5. Once the talus is stabilized on the talotarsal mechanism many things will happen. www.HyProCure.com

6. There will be a significant decrease in strain on many important structures of the foot and ankle! www.HyProCure.com

7. Forefoot valgus- reduced. “Too many toes” sign, abductory twist, posterior tibial tendon dysfunction, over-pronation, adductovarus hammertoes. www.HyProCure.com

8. Forefoot Valgus- reduced. “Too many toes” sign no longer present. www.HyProCure.com

9. Forefoot Valgus- reduced. Abductory twist – decreased shear forces to the ball of the foot. www.HyProCure.com

10. Forefoot Valgus- reduced. Over-pronation is decreased. www.HyProCure.com

11. Forefoot Valgus- reduced. Adductovarus/flexor stabilization digital deformities are also significantly reduced. www.HyProCure.com

12. What do you see? Significant medial talar head bulging, increased pressure and tension on and within the tarsal tunnel decreasing blood flow, traumatizing the posterior tibial nerve, increased strain to posterior tibial tendon? www.HyProCure.com

13. What do you see? Medial dislocation of the talar head, transverse plane deformity- internally stabilized with HyProCure . www.HyProCure.com

14. Hind-foot Effects? Think about the strongest supinator of the foot. The medial bands of the Achilles tendon have a significantly increased strain. The Gastro-Soleal complex has to overcome the hyperpronatory forces to bring the hind-foot back to neutral position along with the tibialis posterior to supinate the foot during the gait cycle. www.HyProCure.com

15. Pre & Post EOTTS withHyProCure® Patient fully weightbearing in relaxed stance position. This post-op photo is 3 weeks post-HyProCure placement. www.HyProCure.com

16. Pre & Post EOTTS withHyProCure® The height of the navicular is maintained therefore stabilizing the arch. www.HyProCure.com

17. Pre & Post HyProCure® www.HyProCure.com

18. Pre & Post HyProCure® www.HyProCure.com

19. Pre & Post HyProCure® Let’s again think about what is occurring in the pre-op foot. The tibialis posterior tendon is being abnormally stretched with every step taken and while standing due to talotarsal dislocation. Immediately upon the insertion of HyProCure this strain is eliminated. Finally the body has a chance to heal the diseased tendon. www.HyProCure.com

20. Can we all agree that this foot has alignment issues? Talus is dislocating on the talotarsal mechanism. This foot is mechanically disadvantage. www.HyProCure.com

21. 3 Days after being HyProCured. www.HyProCure.com

22. 3 Days after being HyProCured. This foot not internally corrected. We don’t have to worry about patient compliance. Excessive strain is eliminated. www.HyProCure.com

23. 3 Days HyProCured. www.HyProCure.com

24. Which foot would you rather have? www.HyProCure.com

25. Let’s take a look at what happens inside. www.HyProCure.com

27. Articulating facets are in complete contact

28. Sinus tarsi is in an “open” position

29. Cyma Line normal

30. Navicular elevatedwww.HyProCure.com

32. Articulating facets are partially displaced

33. Sinus tarsi is partially collapsed/obliterated

34. Anterior deviated Cyma

35. Navicular has dropped.www.HyProCure.com

36. Comparison Normal Abnormal www.HyProCure.com

37. Repositioning of the talus on the tarsal mechanism. HyProCure stabilizes the talus to prevent anterior dislocation. Maintains the articular facets, keeps the sinus open. www.HyProCure.com

38. Talar declination decreased and brought back to normal alignment. HyProCure restores talar position on the tarsal mechanism. www.HyProCure.com

39. Navicular Drop The navicular is forced out of position due to the excessive abnormal forces from the talar displacement. Stabilization of the talus internally prevents navicular drop. www.HyProCure.com

40. What is wrong with this picture. Plantarflexed talus Anterior deviation of cyma Navicular drop Sustentaculum drop This is not a “flat” foot look at the calcaneal inclination angle. Talotarsal subluxation www.HyProCure.com

41. There are so many things realigned. www.HyProCure.com

42. Pediatric Case www.HyProCure.com

43. Weightbearing AP Fluoroscopyshowing transverse plane correction www.HyProCure.com

44. Talar Second Metatarsal Angle www.HyProCure.com

45. Talar Calcaneal Divergence www.HyProCure.com

46. TaloNavicular Articulation www.HyProCure.com

47. 2 Weeks Post-OpThe Knees www.HyProCure.com

48. If we stabilize the TTM than we can also help the rest of the body. www.HyProCure.com

49. “Changing Lives, One Step at a Time” www.hyprocure.com