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

MBA® IMPLANT

Surgical TechniqueSurgical Technique

• Locate the sinus tarsi

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.

Implant InsertionImplant Insertion

This is the proper position for the implant

Subcutaneous closure should approximate the skin edges

ForefootTo

RearfootPosition

IsImproved

Post-op

AFO Boot

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)