Name of the Procedure:

Orthopedic Shoe, Oxford with Supinator or Pronator, Child (HCPCS Code: L3202) Common names: Custom orthopedic shoe, corrective footwear

Summary

Orthopedic shoes for children, specifically designed as oxford-type shoes with built-in supinators or pronators, aim to correct or support irregular foot positioning. These specialized shoes help in proper foot alignment, improving walking patterns and comfort for children with specific foot conditions.

Purpose

Orthopedic shoes with supinators or pronators address foot abnormalities that affect a child's gait and overall posture. They are designed to correct or manage conditions like flat feet (pronation) or high arches (supination). The primary goal is to provide proper foot alignment, enhance stability while walking, and prevent potential future musculoskeletal issues.

Indications

• Flat feet (pronation)
• High arches (supination)
• Corrective needs for abnormal foot positioning
• Children experiencing discomfort or pain due to improper foot alignment

Patient criteria:

• Pediatric patients
• Diagnosis of foot positioning abnormalities by a healthcare provider

Preparation

• A thorough assessment by a podiatrist or orthopedic specialist
• Foot measurement and evaluation for custom-fitting
• No specific preparation such as fasting or medication adjustment is typically required

Procedure Description

1. Evaluation: The child's foot is evaluated for the extent of misalignment and gait issues.
2. Custom Fitting: Measurements are taken, and a custom mold of the foot may be created.
3. Shoe Construction: The orthopedic shoe is designed with a built-in supinator or pronator based on the child’s needs.
4. Fitting: The child tries on the shoe, adjustments are made for comfort and fit.
5. Instructions: Parents/guardians are instructed on proper usage and signs to monitor for effectiveness and fit.

Tools/Equipment:

• Measuring devices,
• Molds for custom fitting,
• Materials for shoe construction.

Duration

The fitting and initial assessment typically take 30 minutes to an hour. The shoe construction period may vary, generally taking a few weeks.

Setting

Orthopedic clinics, hospitals, or specialized outpatient facilities

Personnel

• Orthopedic specialist/podiatrist
• Orthopedic technician/shoe fitter
• Possibly a physical therapist

Risks and Complications

Common risks:

• Initial discomfort or blistering as the foot adjusts Rare risks:
• Incorrect alignment if not properly fitted
• Delay or lack of improvement in gait

Complication management:

• Regular follow-ups for adjustments
• Immediate attention to signs of discomfort

Benefits

• Improved foot alignment and walking pattern
• Reduction in pain or discomfort
• Prevention of future musculoskeletal disorders
• Enhanced overall mobility and quality of life

Expected benefits are usually noticed within a few weeks of consistent use.

Recovery

• No significant recovery period, as this is a non-invasive procedure
• Regular wear as instructed by the healthcare provider
• Follow-up assessments to ensure proper fit and adjustments

Alternatives

• Standard orthopedic insoles
• Physical therapy for strengthening and alignment
• Custom orthotic inserts

Pros and cons of alternatives:

• Insoles and inserts are less costly but might offer less support.
• Physical therapy focuses on muscle strengthening but may not correct foot positioning as effectively.
• Custom orthopedic shoes provide comprehensive support, though they are more expensive and require a longer fitting process.

Patient Experience

During the fitting:

• The child might feel minor discomfort while being evaluated and during the initial fitting process.

After the fitting:

• Mild discomfort or an adjustment period may occur as the feet adapt to the new support.
• Regular follow-ups ensure sustained comfort and effectiveness.
• Pain management through recommendations by a healthcare provider if necessary.