Effect of custom-made foot orthoses in female hallux valgus after one-year follow up.

BACKGROUND: Subtalar joint hyperpronation plays a fundamental role in the development of hallux valgus (HV). Foot orthotics have used to treat this condition and are aimed at preventing progression of the deformity.

OBJECTIVES: The aim of this study was to determine if the use of custom-made foot orthotics for 12 months prevented the advancement of HV in women.

STUDY DESIGN: Prospective trial, using a repeated-measures design.

METHODS: Fifty-four women with mild to moderate HV were divided into two groups: the experimental group used custom-made foot orthoses, and the control group used no treatment. First intermetatarsal (IMA) and hallux abductus (HAA) angles were measured at the beginning of the study and after 12-months follow up. Inter-group comparisons were made of these angles at both times of measurement, and intra-group comparisons between the two times of measurement.

RESULTS: The initial HAA was similar in both groups (19.92 ± 4.25 degrees for the control group, 20.55 ± 5.10 degrees for the experimental group; p = 0.392), and also the IMA (10.56 ± 2.45 degrees for the control group, 10.86 ± 2.33 for the experimental group; p = 0.618) There were no significant differences in the follow-up values of these angles (p = 0.395 and p = 0.288, respectively). There were no significant intra-group differences in the comparisons of the initial and follow-up angles.

CONCLUSIONS: HV did not have a significantly slower evolution in participants of the experimental group compared with controls. Custom-made orthoses appear to have no effect in the evolution of mild and moderate HV during a 12 month period. Clinical relevance Subtalar joint hyperpronation plays a fundamental role in the development of hallux valgus. Conservative management typically involves the use of foot orthotics which is aimed at preventing the progress of the condition. The use of foot orthotics however should be used as a long term management strategy (beyond 12 months).