Foot Orthoses: A Systematic Review
A systematic review and metanalysis published in Clinical Biomechanics has investigated the “effects of foot orthoses, based on their design, in terms of lower limb kinematics and kinetics in people with pes planovalgus.”
“Peer-reviewed journal studies including adult participants with flexible pes planovalgus and reporting kinematics and kinetics effects of foot orthoses during walking were included and classified based on the orthosis design.”
The findings suggested that anti-pronatory components were necessary to induce a “positive biomechanical effect” and medial posting is an appropriate intervention. Arch supports on their own however, were not shown to be of any benefit.
Gaps were still found in the body of research available with weak evidence for foot orthoses to manage gait features. The authors concluded “studies of higher quality are required to facilitate flat feet clinical management.”
New Finite Element Model to Investigate Flatfoot
Researchers who have published recently in the Journal of Orthopaedics, have developed a comprehensive 3D Finite Element model of the foot “to investigate the effect of soft tissue stiffness on the plantar pressure distributions and the internal load transfer between bony structures” in flat and normal feet.
Baropodometric analyses and the finite element models were employed to investigate the stress shielding which occurs on the plantar surface of a “flatfoot” compared to a “healthy foot.”
A stress shielding map was created which showed significant pressure acting on the medial plantar fascia in the flat foot compared to the healthy foot. The researchers concluded “symptomatic adult flatfoot is a complex abnormality involving all three dimensions and multiple joints within the foot.”
No Rush to Treat Polydactyly
According to a new study published in the Journal of Foot and Ankle Surgery, there is no hurry to operate on children with polydactyly.
The retrospective study investigated patients who had received surgery between 1995 and 2009 and compared the long-term results of children treated before and after 5 years of age.
The results showed little difference between the 2 groups and suggested that “most surgically treated polydactyly cases tend to do well in the long run”. The authors also suggested that there may be some benefit in allowing the foot to grow in order to help reveal the full deformity before surgery is performed.