July 2010

Orthosis study favors three-quarter length for patients with hallux valgus

In the moment: Footcare

A study from the University of Tennessee supports the use of a three-quarter length custom orthosis for patients with hallux valgus deformity.

The study compared custom orthoses of full, three-quarter, and sulcus lengths. The orthoses were worn by 25 patients (38 feet with hallux valgus) during gait.

Plantar pressures at the first metatarsal head decreased significantly with the full-length and three-quarter length orthoses. There was also a trend toward decrease medial pressure with the three-quarter length orthoses only. Dorsal pressures, on the other hand, increased significantly with the full and sulcus length orthoses but not the three-quarter length orthoses.

“The increased dorsal pressure may irritate the dorsal medial cutaneous nerve at the top of the shoe,” said Jesse Doty, MD, an orthopaedic surgery resident, who presented the group’s findings in July at the AOFAS meeting.

Doty acknowledged that roomier shoes could offset any increased dorsal pressure, but noted that this is not always an option.

“Often in our part of the country orthoses are prescribed for hallux valgus rather than a special shoe,” he said.

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