Correction of hypermobile flatfoot in children by molded insert

One hundred feet in 50 children between the ages of 3 and 9 years with a diagnosis of idiopathic hypermobile flatfoot had a custom-molded insert ordered. A specific method of casting, correcting the various components of the deformity was utilized. An 1/8-inch polypropolene insert was fabricated from the positive cast. The insert was worn in leather shoes with a long counter, steel shank, and Thomas heel. The flatfoot was evaluated and classified by measurement of the talometatarsal angle on a standing lateral X-ray. The insert was fabricated so that the standing lateral talometatarsal angle was corrected to neutral with the insert on the foot and the foot in the shoe. The preliminary reports indicate that a correction can be obtained at the rate of 0.41 degrees per month or approximately 5 degrees per year. There was no significant loss of motion of the foot or the ankle. Perhaps this regimen may be utilized in those children with a hypermobile flatfoot for whom treatment is advised.