title: Do corrective shoes improve the development of the medial longitudinal arch in children with flexible flat feet?
abstract: BACKGROUND
  Flexible flatfoot, as the most prevalent foot deformity in pediatric population still has no standardized strategy for its management hence some orthopedic surgeons have the tendency to use orthotic devices. The objective of this study is to evaluate whether orthotic shoes effect the natural course of the developing medial longitudinal arch in children diagnosed with moderate flexible flatfoot.
  
  
  METHODS
  Fourty-five children (33 boys and 12 girls) with moderate flexible flatfoot were enrolled in this study. They were followed up for 34.6 ± 10.9 months (24-57 months). Patients in group 1 were treated with corrective shoes whereas group 2 was left untreated. Patients were evaluated according to; general joint laxity, arch index, lateral talo-first metatarsal (TM), talo-horizontal (TH), calcaneal pitch (CP), lateral and anterior talocalcaneal (TC) angles.
  
  
  RESULTS
  Although there was a significant decrease in general laxity in both groups, decrease of laxity percentage was not significant between groups (p = 0.812). TM, TH and anterior TC angles were found to be decreased in groups whereas there was no difference between group 1 and 2. The arch index was found to be correlated with TM and TH angles in both groups (p = 0.004, p = 0.013).
  
  
  CONCLUSIONS
  Corrective shoes for flexible flatfoot was found not effective on development of foot arches. Therefore, they should be limited only for selected cases.
authors.affiliation: Gazi University School of Medicine, Department of Orthopaedics, Ankara, Turkey.
authors.forename: Ulunay
authors.initials: U
authors.lastname: Kanatlı
authors.affiliation: Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Department of Orthopaedics, Ankara, Turkey. Electronic address: drerdem2007@gmail.com.
authors.forename: Erdem
authors.initials: E
authors.lastname: Aktas
authors.affiliation: Gazi University School of Medicine, Department of Orthopaedics, Ankara, Turkey.
authors.forename: Haluk
authors.initials: H
authors.lastname: Yetkin
mesh_terms: D000293:Adolescent; D002648:Child; D002657:Child Development / Q000502:physiology; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005413:Flatfoot / Q000175:diagnosis* / Q000534:rehabilitation*; D005500:Follow-Up Studies; D005528:Foot / Q000033:anatomy & histology* / Q000254:growth & development; D006801:Humans; D008297:Male; D009989:Orthotic Devices / Q000706:statistics & numerical data*; D010372:Pediatrics; D012775:Shoes