Do corrective shoes improve the development of the medial longitudinal arch in children with flexible flat feet?

Abstract

Flexible flatfoot, as the most prevalent foot deformity in pediatric population still has no standardized strategy for its management hence some orthopedic surgeons have the tendency to use orthotic devices. The objective of this study is to evaluate whether orthotic shoes effect the natural course of the developing medial longitudinal arch in children diagnosed with moderate flexible flatfoot. Fourty-five children (33 boys and 12 girls) with moderate flexible flatfoot were enrolled in this study. They were followed up for 34.6±10.9 months (24-57 months). Patients in group 1 were treated with corrective shoes whereas group 2 was left untreated. Patients were evaluated according to; general joint laxity, arch index, lateral talo-first metatarsal (TM), talo-horizontal (TH), calcaneal pitch (CP), lateral and anterior talocalcaneal (TC) angles. Although there was a significant decrease in general laxity in both groups, decrease of laxity percentage was not significant between groups (p=0.812). TM, TH and anterior TC angles were found to be decreased in groups whereas there was no difference between group 1 and 2. The arch index was found to be correlated with TM and TH angles in both groups (p=0.004, p=0.013). Corrective shoes for flexible flatfoot was found not effective on development of foot arches. Therefore, they should be limited only for selected cases.