When would you prescribe functional foot orthoses following bunion surgery?
For most hallux valgus patients, David Levine, DPM, CPed, would recommend orthotic devices. “Even more important than orthotic devices is educating the patient about footwear and what to look for,” he advises. “Once (patients are) in the appropriate footwear, then the function and performance of orthotic devices will make a lot more sense as well as increase the chances of patient adherence.” Michael Burns, DPM, considers hallux valgus deformity a symptom of midstance midfoot instability and functional hallux limitus. He always suggests orthotic control following hallux valgus repair unless the midstance instability has improved following a Lapidus fusion or some other ancillary procedure. In practice, he encourages patients with first metatarsophalangeal joint (MPJ) pain to try orthotic control before surgery (unless there is secondary involvement of the second MPJ). Dr. Burns maintains that the symptoms often resolve without surgery. “This allows the patient a reasonable option regar
