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).

Orthotic devices with out-toeing wedge combined with correctly fitting shoes, as well as shoes alone, are useful tools in the treatment of in-toed gait in children.

We performed a bibliographic review of the systems proposed by various researchers to evaluate physiologic metatarsal protrusion. The system of measurement devised by Hardy and Clapham to evaluate the protrusion between the first and second metatarsals was adapted to study the whole metatarsal parabola. We studied the five metatarsals of 52 normal feet. Mean metatarsal protrusion relative to the second metatarsal was +1.21% for the first metatarsal, -3.84% for the third metatarsal, -9.66% for the fourth metatarsal, and -16.91% for the fifth metatarsal.

The aim of this study was to determine whether the treatment of abnormal subtalar pronation restores functional (as opposed to structural) limited dorsiflexion of the first metatarsophalangeal joint (functional hallux limitus). We studied 16 feet of eight individuals with abnormal subtalar pronation. Orthoses were made for all of the feet, and hallux dorsiflexion was measured during weightbearing. Each patient was unshod without the orthosis, unshod with the orthosis fitted on the same day, and unshod with the orthosis fitted approximately 5 months later. The results suggest that in functional hallux limitus caused by abnormal subtalar pronation, hallux dorsiflexion will gradually be restored by the use of foot orthoses to control the abnormal subtalar pronation.