Corrective shoes for children: a survey of current practice

A survey of shoe-prescribing practices for children was taken among pediatricians, orthopaedists, pediatric orthopaedists, and podiatrists. Opinions differed significantly regarding the usefulness of shoe modifications for common pediatric lower limb and foot problems. Parents' attitudes toward children's shoes were also surveyed. Pediatricians and pediatric orthopaedists tended to prescribe corrective shoes less often than did orthopaedists and podiatrists. High topped shoes are not necessary to promote normal foot development, in the opinion of 85% of those surveyed; however, high topped shoes were often recommended for infants because they slip off less easily. Preferences for Thomas heels, scaphoid pads, reverse lasts, straight lasts, wedges, torque heels, and shoe lifts for problems including flexible flat feet, metatarsus adductus, intoeing, bow legs, knock knees, and leg length inequalities were delineated among the four groups treating children's feet. The authors conclude that whereas studies show that shoe modifications are of questionable value in the problems discussed, corrective shoes are often prescribed when regular shoes would be more appropriate and economical.