THE MAXWELL- BRANCHEAU ARTHRORESIS (MBA)IMPLANT FOR FLEXIBLE FLATFOOT.
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Transcript of THE MAXWELL- BRANCHEAU ARTHRORESIS (MBA)IMPLANT FOR FLEXIBLE FLATFOOT.
THE MAXWELL-THE MAXWELL-BRANCHEAU BRANCHEAU
ARTHRORESIS ARTHRORESIS (MBA)IMPLANT FOR (MBA)IMPLANT FOR
FLEXIBLE FLATFOOT FLEXIBLE FLATFOOT
IntroductionIntroduction
• Excessive Pronation hypermobile foot during propulsion phase
of gait
•Arthroereisis Concept allow for normal subtalar joint motion while blocking excessive motion (normal = 4-6 degrees pronation)
SymptomsSymptoms
Foot fatigueLeg and arch painNight crampsWalking intemperanceAthletic abstinenceSedentary hobby pursuitAbnormal shoe wear
The IncisionThe Incision
Incision – 1-3cm* over sinus tarsi along the relaxed skin tension lines
Care should be taken to avoid the intermediate dorsal cutaneous nerves as well as the sural nerve.
DissectionDissection
The deep fascia is identified an opened allowing entrance into the sinus tarsi.
Probe InsertionProbe Insertion The yellow probe
instrument is positioned perpendicular to the wall of the calcaneus, angled slightly posterior and superior, and inserted through the sinus tarsi into the sinus canalis until tenting is noted on the medial aspect of the foot.
Guide wire InsertionGuide wire Insertion
A guide pin is then inserted.
A medial incision is not recommended.
MBA INCIDENTALSMBA INCIDENTALS
Schedule one foot at a time.Allow crutches as needed.It is better to under correct.Advise parent of temporary in-toe gait after
surgery.Use “Derma Bond” if child is apprehensive.
(Adjunctive procedures if indicated)