Immediate effect of prefabricated and UCBL foot orthoses on alignment of midfoot and forefoot in young people with symptomatic flexible flatfoot: A radiographic evaluation

Background: Radiographic imaging has been considered the gold standard in evaluating the skeletal alignment of the foot in static weightbearing. The effects of foot orthoses on the alignment of foot bones have been mostly evaluated using lateral view x-rays. The posterior-anterior view has not been investigated extensively. Objectives: To investigate the effects of 2 foot orthoses: University of California Biomechanics Laboratory Orthosis (UCBL) and a prefabricated orthosis (P-FFO) on the alignment of foot bones on anterior-posterior x-rays in young people with symptomatic flexible flatfoot (SFF). Study Design: This is a randomized, crossover study. Methods: Fifteen participants (mean [SD], 23.67 +/- 2 years) with SFF were randomly imaged in 3 different conditions: shoes only, shoes + P-FFO, and shoes + UCBL. The talonavicular coverage, the first and the second talometatarsal angles, the intermetatarsal angle, and the cuboid abduction angle (CAA) were measured on weightbearing, anterior-posterior x-ray images for each condition. Results: Both orthotic designs demonstrated a significant reduction in the talonavicular coverage, the first and the second tabmetatarsal angles, and the CAA compared with the shoe-only condition (P < .001). The talonavicular coverage angle reduced by similar to 11% using P-FFO compared with UCBL (P < .005). No significant differences were observed for other angles between the 2 orthotic conditions. Conclusions: Both orthotic conditions improved the talonavicular coverage, first and the second talometatarsal angle, and CM in young people with SFF. The walls of the UCBL orthosis did not result in further correction of the talonavicular coverage angle compared with the prefabricated FFO design.