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Clinical Solutions in Practice

Can Unique Prefabricated Orthoses Have An Impact For Pediatric Flexible Flatfoot?

Podiatry Today Staff
February 2011

Are you looking for affordable orthotic alternatives that offer resilient materials, good arch contours and easy sizing to help correct pediatric flexible flatfoot?

   Kiddythotics offer a variety of benefits, according to the manufacturer ProLab Orthotics. The company notes the functionally corrected prefabricated devices feature a deep heel cup, a medial flange, a medial heel skive and a rearfoot post incorporated into a rigid polypropylene shell.

   Russell Volpe, DPM, praises the Kiddythotics for having a solid, controlling shell, good arch contour, reasonable heel depth and acceptable control.

    “I like (Kiddythotics) as a first device in young toddlers with mild to moderate deformity,” notes Dr. Volpe, a Professor in the Departments of Pediatrics and Orthopedics at the New York College of Podiatric Medicine. “I use them primarily for children between the ages of 1 and 3. However, I will extend this to children older than this if there are financial or clinical circumstances that lead me to choose a prefab device in a particular child.”

   Ronald Valmassy, DPM, has been utilizing Kiddythotics for a number of years and has been pleased with the results. Dr. Valmassy says he typically uses Kiddythotics for any youngster (usually between the ages of 2 and 5) who demonstrates marked abnormal pronation.

    “There have been cases when I have utilized (Kiddythotics) for an early walker to help stabilize gait for those under the age of 2. Depending on the overall foot size and function, I have utilized them for children who are somewhat older,” explains Dr. Valmassy, a staff podiatrist at the Center for Sports Medicine at the St. Francis Memorial Hospital in San Francisco.

   Dr. Valmassy says a key attribute of the Kiddythotics is easy sizing, which enables him to utilize them for a number of patients. Dr. Valmassy also cites the extremely resilient materials of the Kiddythotics. One can also modify the devices when appropriate, according to Dr. Valmassy, a Professor and Past Chairman of the Department of Podiatric Biomechanics at the California School of Podiatric Medicine at Samuel Merritt University in Oakland, Calif.

    “They are very easy to modify by grinding and by adding additional forefoot and rearfoot varus posting,” notes Dr. Valmassy.

   Drs. Valmassy and Volpe also note that the cost of the Kiddythotics is a “primary advantage.”

    “(The cost) is a fraction of that of a custom device and this can be a real plus for young toddlers who may outgrow devices more quickly,” says Dr. Volpe, who is in private practice in Farmingdale, N.Y.

   In terms of possible drawbacks or contraindications, Dr. Volpe says Kiddythotics “can be too narrow for wider, excessively pronated feet,” but notes this is a problem with most prefab devices. Dr. Valmassy adds that the Kiddythotics would not replace the use of functional foot orthoses in children with hypermobile flexible flatfoot, especially if the child has developed a heel-to-toe type of gait pattern.

   Overall, though, Dr. Valmassy feels the Kiddythotics are a viable option for pediatric flatfoot issues.

    “I feel they are quite effective in dealing with pediatric flatfoot problems and I find there is generally very good acceptance on the part of both the child and the parents,” notes Dr. Valmassy.

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