Orthoses for Juvenile Hallux Valgus

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Hi,

I'm looking to treat a juvenile (14yrs) Hallux Valgus. With limited resources here in Greece I struggle to make custom orthoses, so want to explore the option of ready made with chairside alterations if needed.

Does anyone know of, or can recommend an insole which may be suitable?

Thanks

Sara

 

You might want to lower hallux dorsiflexion stiffness, so something with a kinetic wedge modification might be helpful, you can buy a preform and put a full length top-cover with a kinetic wedge modification on lots and lots of devices.

 

The thing is , to treat or not to treat. Tim Kilmartin did a fantastic research study into treating hv in the ped patient and basically there was no improvement. Will try and find title of paper. If you want to treat, there is a cast insole from Langer called the DSIS. (dynamic stabilising inner sole). It is smaller than a 3/4 and was devised by Redmond, (I think).

 

As Simon said, something to lower DF stiffness at the 1st MPJ might help

Here are a couple a very good prefabs (one of which is) designed specifically with that in mind

http://www.vasylimedical.com/products/product_howard_dananberg.html

and http://www.interpod.com.au/ - interpod control tech flex - comes with a top cover that has a 1st MPJ window

Hope this helps

 

I am fully aware of the Kilmartin study. However, the specific type of foot orthoses employed within that study in all probability did not lower the hallux dorsiflexion stiffness. Rather, they probably increased it.

http://web.jbjs.org.uk/content/76-B/2/210.full.pdf
http://www.ncbi.nlm.nih.gov/pubmed/1920102

 

Thank you all for your input. I had a good read of the threads on Juvenile HAV (a section I tried searching for before posting but couldn't find!) which was very helpful. The plan is to proceed conservatively as she isn't experiencing pain, so footwear advice and info on possible treatments including a splint have been given.

 

Why are none of you mentioning the Subtalar Joint Axis or its rotational equilibrium in constructing or selecting an orthosis here?

You seem to be focusing on the forefoot?

Dennis