Nonoperative Treatment of Müller-Weiss Disease: The Spanish Experience

Müller-Weiss disease has been studied and reported more frequently in Spain than elsewhere. We discuss its nonoperative treatment focusing especially on orthotics used for rebalancing and accommodating the complex flatfoot varus deformity. Review of the few publications on this subject topic reveals important biases. For treatment of asymmetric talonavicular arthritis with associated longitudinal arch collapse, insoles incorporating medial arch supports with pronator wedges may eliminate supination forces acting on soft tissues of the lateral hindfoot and compressive forces on the dorsal midtarsal joints. Design modification and quantification of insole features, depending upon disease stage, are of paramount importance for relieving pain and improving function.