Name of the Procedure:

Orthopedic Shoe, Hightop with Supinator or Pronator, Infant (HCPCS Code: L3204) Common names: Orthopedic baby shoes, Customized infant hightop shoes

Summary

Orthopedic hightop shoes designed for infants provide additional ankle support and correctional alignment to address issues related to overpronation or supination of the feet.

Purpose

Orthopedic hightop shoes are used to correct and support abnormal foot positioning in infants. They help ensure proper foot development and reduce discomfort associated with foot misalignment.

Indications

• Overpronation (foot rolling inward)
• Supination (foot rolling outward)
• Developmental dysplasia of the hip (DDH)
• Congenital foot deformities
• Early signs of flat feet

Preparation

No special preparation is needed for the infant. A fitting session with an orthopedic specialist is required to tailor the shoe to the child's specific needs. Prior diagnostic assessments may include:

• Physical examination
• Imaging tests such as X-rays or ultrasounds

Procedure Description

1. Initial Assessment: The orthopedic specialist evaluates the infant's foot structure and alignment.
2. Fitting and Customization: The specialist measures the infant's feet to create a custom fit. Adjustments are made to the built-in supinator or pronator based on the specific needs.
3. Fitting Session: The shoes are fitted onto the infant's feet, ensuring a snug but comfortable fit.
4. Instruction: Caregivers are educated on proper use and maintenance of the shoes.

Duration

The entire process, including assessment and customization, typically takes about 1-2 hours.

Setting

The procedure is usually performed in an orthopedic clinic or specialized children's outpatient center.

Personnel

• Orthopedic specialist
• Orthotist (a healthcare professional specialized in orthopedic braces and supports)
• Pediatric nurse (occasionally)

Risks and Complications

• Skin irritation or blisters due to improper fit
• Discomfort if not worn correctly
• Potential delay in addressing severe alignment issues if not effective

Benefits

• Improved foot alignment and support
• Enhanced development of the infant's gait and posture
• Reduction in discomfort and potential future foot problems

Recovery

The infant can resume normal activities immediately with the shoes on. Follow-up appointments to monitor progress and shoe adjustments may be necessary. Regular use as directed by the specialist is essential.

Alternatives

• Physical therapy exercises to strengthen the feet and ankles
• Custom orthotic insoles to be used with regular shoes
• Observation with routine follow-ups for mild cases

Pros of Orthopedic Shoes:

• Immediate support and correction
• Customized to the infant's specific needs

Cons of Alternatives:

• May not provide enough support
• Longer period to see effective results

Patient Experience

The infant may initially show signs of discomfort or resistance to wearing the new shoes but will typically adapt within a few days. Caregivers should ensure proper fit and seek adjustments if the infant shows persistent discomfort. Maintenance of a clean and dry interior of the shoe is essential to prevent skin irritation.