title: Biomechanical Evaluation of Custom Foot Orthoses for Hallux Valgus Deformity.
abstract: The purpose of the present study was to compare the hallux valgus deformity pressure parameters seen in standard footwear (no orthosis) versus the pressure observed in the same footwear with the addition of 3 different length orthoses. The forefoot pressure at a hallux valgus deformity was recorded with pressure sensors placed on the plantar, medial, and dorsal surface of the first metatarsal head. The participants performed walking trials without an orthosis and with orthoses of 3 different lengths. The average pressure and maximum pressure of each area was recorded for each orthosis, and comparisons were made across the groups. The plantar pressures were decreased in the full length and 3/4 length orthoses, and the dorsal pressures were increased with the use of the full-length and sulcus-length orthoses. Significant changes in medial pressure were not seen with the addition of any orthosis compared with standard footwear alone. However, a trend toward increased medial pressures was seen with the full- and sulcus-length orthoses, and the 3/4-length orthoses exhibited a trend toward decreased medial pressures. We were unable to demonstrate that the use of a custom foot orthosis significantly decreases the medial pressures on the first metatarsal head in patients with hallux valgus deformity. The 3/4-length orthosis was less likely to negatively affect the dorsal or medial pressures, which were noted to increase with the sulcus- and full-length orthoses. Our data suggest that if a clinician uses this treatment option, a 3/4-length orthosis might be a better choice than a sulcus- or full-length orthosis.
authors.affiliation: Clinical Instructor, Department of Orthopaedic Surgery, University of Tennessee College of Medicine, Chattanooga, TN. Electronic address: jessd90@hotmail.com.
authors.forename: Jesse F
authors.initials: JF
authors.lastname: Doty
authors.affiliation: Professor and Chairman, Department of Orthopaedic Surgery, University of Tennessee College of Medicine, Chattanooga, TN.
authors.forename: Richard G
authors.initials: RG
authors.lastname: Alvarez
authors.affiliation: Department of Orthopaedic Surgery, University of Tennessee College of Medicine, Chattanooga, TN.
authors.forename: Timothy B
authors.initials: TB
authors.lastname: Ervin
authors.affiliation: Center for Orthotic and Prosthetic Care, Duke University, Durham, NC.
authors.forename: Ashley
authors.initials: A
authors.lastname: Heard
authors.affiliation: Southeastern Orthotics, Chattanooga, TN.
authors.forename: John
authors.initials: J
authors.lastname: Gilbreath
authors.affiliation: Orthopaedic Resident, Department of Orthopaedic Surgery, University of Tennessee College of Medicine, Chattanooga, TN.
authors.forename: Nicholas S
authors.initials: NS
authors.lastname: Richardson
mesh_terms: D000328:Adult; D001696:Biomechanical Phenomena; D004867:Equipment Design; D005260:Female; D005531:Foot Deformities, Acquired / Q000175:diagnosis / Q000534:rehabilitation; D061826:Foot Orthoses; D006215:Hallux Valgus / Q000175:diagnosis* / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011312:Pressure; D012720:Severity of Illness Index; D016138:Walking / Q000502:physiology*
keywords: Tactilus Free Form(®) Sensor system; bunion; forefoot; metatarsal; orthosis; pressure