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Corrective shoes and inserts as treatment for flexible flatfoot in infants and children
Wenger DR, Mauldin D, Speck G, Morgan D, Lieber RL
Journal of Bone and Joint Surgery -- American Volume 1989 Jul;71(6):800-810
clinical trial
5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

We performed a prospective study to determine whether flexible flatfoot in children can be influenced by treatment. One hundred and twenty-nine children who had been referred by pediatricians, and for whom the radiographic findings met the criteria for flatfoot, were randomly assigned to one of four groups: group I, controls; group II, treatment with corrective orthopaedic shoes; group III, treatment with a Helfet heel-cup; or group IV, treatment with a custom-molded plastic insert. All of the patients in groups II, III, and IV had a minimum of three years of treatment, and ninety-eight patients whose compliance with the protocol was documented completed the study. Analysis of radiographs before treatment and at the most recent follow-up demonstrated a significant improvement in all groups (p < 0.01), including the controls, and no significant difference between the controls and the treated patients (p > 0.4). We concluded that wearing corrective shoes or inserts for three years does not influence the course of flexible flatfoot in children.

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