Review of the effectiveness of molded insoles in pediatric flatfoot

Pediatric flatfoot is one of the pathologies that are presented most frequently in orthopedic and podiatry clinical practice. It is also a common concern to parents and it continues being a debated topic by healthcare professionals. We carried out a bibliographic search in order to evaluate the effectiveness of orthopedic treatment by using molded insoles in children with flatfoot. Reports that evaluate the immediate effect of molded insoles, comparing the changes wearing or not the orthopedic treatment, agree that the molded insoles reduce the degrees of eversion of the calcaneus in standing position and also reduce the percentage of maximum eversion, and of total eversion in dynamic positioning. The effectiveness of molded insoles in pediatric flatfoot when the analysis is carried out in long-term longitudinal studies is controversial. Conclusion: the effectiveness of molded insoles in long-term evaluation depends on the child age and the duration of the treatment. Effectiveness increases when the child is over six years old and when the treatment is over 24 months. There are no studies suggesting that the use of molded insoles difficult the normal development of the foot or worsen the situation in which the foot is at the time of initiation of treatment.