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Foot orthotics for hallux limitus

Discussion in 'Biomechanics, Sports and Foot orthoses' started by NewsBot, Jun 11, 2015.

  1. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1

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    Effect by custom-made foot orthoses with added support under the first metatarso-phalangeal joint in hallux limitus patients: Improving on first metatarso-phalangeal joint extension
    Luis María Gordillo-Fernández et al
    Prosthet Orthot Int June 10, 2015
     
  2. Christian McErvale

    Christian McErvale Welcome New Poster

    Anyone know what this support looked like? Assuming it is NOT a Morton's extension?
     
  3. Griff

    Griff Moderator

    Like this:
     

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  4. footdoctor

    footdoctor Active Member

    How on earth did that improve functionality of the 1st mpj?
     
  5. efuller

    efuller MVP

    I wonder if they controlled for muscular activity while assessing joint range of motion.
     
  6. BillyAlexander

    BillyAlexander Welcome New Poster

    adding a 1st met bar may be a good idea for a pt with a Morton's foot, where the 1st met struggles to contact the ground and therefore increasing pronatory force during forefoot loading. your thoughts?
     
  7. josefcef

    josefcef Member

    how can a plantar support to the 1st mpj increase its functionality? I think that it will increase the stiffness of the joint since it is putting more pressure during gait!! As far as I am concerned usually when there is hallux limitus or rigidus a first ray cut out is utilized to spread the pressure on the other mets and reduce it from the 1st mpj which is not functioning properly and if there is no improvement.... pt should be referred for a steroid injection or chilectomy. What do you think? :D
     
  8. I would use the above in Hallux limitus when the joint is very painful and the next step in treatment is surgery, I have used it successfully to get patients a few more months before the op time was found , never to improve function in the joint though makes little mechanical sense
     
  9. Geoffo

    Geoffo Member

    I have always found that by adding a pad to the dorsal surface of the orthotic or creating an orthotic with an increased dorsal lip, ie a ff post built in, it causes the joint to open and reduces pressure on the lipping at the top of the joint. From a pain reduction point of view, it works very well. Personally I wouldn't make the bar as long, as I think you need to allow the toe to plantarflex relative to the met.
     
  10. Ben Lovett

    Ben Lovett Active Member

    What they measured here was the passive non weightbearing extension of the hallux prior to using the orthoses and again after using orthoses for 6 months.
    There was no dynamic assessment and no assessment of any change in functional range of motion with the different orthoses.
    What they are claiming is that adding a flexible Morton's extension to the orthotic increases the structural non weight bearing ROM after 6 months.
    There is no indication as to whether the study population was symptomatic or whether the intervention reduced or increased symptoms.

    Ben
     
  11. 56Furman

    56Furman Member

    I have seen inaccurate 1st MPT dorsiflexion results in PT reports. Initial findings limited 1st MPT, after 2 months of therapy 20-30 degrees. Yet when I exam the the patient there is limited 1st MPT motion. I believe the greater achieved dorsiflexion is coming from measuring hyper flexion at the hallux IPJ at the end of therapy. The authors of this study also probably measured to the most distal aspect of the hallux therefore factoring in the dorsal hyper mobility of the IPJ
     
  12. Bigfoot09

    Bigfoot09 Welcome New Poster

    Hi

    also it is not exactly this topic. I am looking for this paper. Does anyone know where I can get it?

    Juriansz A. Conservative treatment of hallux values: A randomised controlled trial of a hallux valgus night splint. J Br. Podiatry. Med 1996; 51; 119.

    or does anyone know other paper for this topic.

    Best regards

    Bigfoot.
     
  13. jane grey

    jane grey Welcome New Poster

    Kisses
     

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