Shoe Inserts
Many orthopedic and neurologic pediatric disorders have sequelae that require orthotic management. Shoe inserts may be a viable option in many circumstances. There are many commercially available products to control differing levels of impairment in the hindfoot, midfoot, and forefoot.
Heel cups help with shock absorption for joints, heel spurs, bursitis, and tendonitis. In the midfoot, orthoses assist to maintain the arch of the foot in varying degrees of firmness. Numerous products are also available to control disorders of the forefoot and toes. To relieve metatarsalgia, metatarsal bars are available to unload pressure from the metatarsal arch. Pads are available to help to realign hammer and claw toes, cushion bunions and calluses, and to protect toes from friction and irritation. A limitation to these commercially available products is that many times they do not come in pediatric sizes and must be modified to fit.
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