Evidence for orthotic treatment of the forefoot

Systematic Reviews

Cabrera-Sánchez, J.M., Reina-Bueno, M., Palomo-Toucedo, I.C., Vázquez-Bautista, M.D.C., Núñez-Baila, M.Á. and González-López, J.R., 2024, October. Effect of Foot Orthoses and Footwear in People with Rheumatoid Arthritis: An Updated Systematic Review. In Healthcare (Vol. 12, No. 20, p. 2017). MDPI.
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Hutchins, S., Bowker, P., Geary, N. and Richards, J., 2009. The biomechanics and clinical efficacy of footwear adapted with rocker profiles—evidence in the literature. The Foot, 19(3), pp.165-170.
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Hutchins, S., Bowker, P., Geary, N. and Richards, J., 2009. The biomechanics and clinical efficacy of footwear adapted with rocker profiles—evidence in the literature. The Foot, 19(3), pp.165-170.
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Kunnasegaran, R. and Thevendran, G., 2015. Hallux Rigidus: Nonoperative Treatment and Orthotics. Foot and ankle clinics, 20(3), pp.401-412.
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Munteanu, S.E., Buldt, A., Lithgow, M.J., Cotchett, M., Landorf, K.B. and Menz, H.B., 2024. Non‐surgical interventions for treating osteoarthritis of the big toe joint. Cochrane Database of Systematic Reviews, (6).
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Robinson, A.H.N. and Limbers, J.P., 2005. Modern concepts in the treatment of hallux valgus. The Journal of bone and joint surgery. British volume, 87(8), pp.1038-1045.
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Robinson, A.H.N. and Limbers, J.P., 2005. Modern concepts in the treatment of hallux valgus. The Journal of bone and joint surgery. British volume, 87(8), pp.1038-1045.
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Interventional Studies

McClelland, J.A., Allan, J.J., Auhl, M., Buldt, A.K., Landorf, K.B., Cicuttini, F.M., Roddy, E., Menz, H.B. and Munteanu, S.E., 2022. Effects of Shoe‐Stiffening Inserts on Lower Extremity Kinematics in Individuals With First Metatarsophalangeal Joint Osteoarthritis. Arthritis Care & Research, 74(11), pp.1849-1856.
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Menz, H.B., Auhl, M., Tan, J.M., Levinger, P., Roddy, E. and Munteanu, S.E., 2016. Effectiveness of Foot Orthoses Versus Rocker‐Sole Footwear for First Metatarsophalangeal Joint Osteoarthritis: Randomized Trial. Arthritis care & research, 68(5), pp.581-589.
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Menz, H.B., Auhl, M., Tan, J.M., Levinger, P., Roddy, E. and Munteanu, S.E., 2016. Biomechanical effects of prefabricated foot orthoses and rocker‐sole footwear in individuals with first metatarsophalangeal joint osteoarthritis. Arthritis care & research, 68(5), pp.603-611.
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Menz, H.B., Auhl, M., Tan, J.M., Levinger, P., Roddy, E. and Munteanu, S.E., 2017. Predictors of response to prefabricated foot orthoses or rocker-sole footwear in individuals with first metatarsophalangeal joint osteoarthritis. BMC musculoskeletal disorders, 18(1), p.185.
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van der Zwaard, B.C., Poppe, E., Vanwanseele, B., van der Horst, H.E. and Elders, P.J., 2014. Development and evaluation of a leaflet containing shoe advice: a randomized controlled trial. Family practice, 31(3), pp.267-272.
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van der Zwaard, B.C., van der Horst, H.E., Knol, D.L., Vanwanseele, B. and Elders, P.J., 2014. Treatment of forefoot problems in older people: a randomized clinical trial comparing podiatric treatment with standardized shoe advice. The Annals of Family Medicine, 12(5), pp.432-440.
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Observational Studies

Borchgrevink, G.E., Viset, A.T., Witsø, E., Schei, B. and Foss, O.A., 2016. Does the use of high-heeled shoes lead to fore-foot pathology? A controlled cohort study comprising 197 women. Foot and Ankle Surgery, 22(4), pp.239-243.
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Brown, D., Wertsch, J.J., Harris, G.F., Klein, J. and Janisse, D., 2004. Effect of rocker soles on plantar pressures1. Archives of physical medicine and rehabilitation, 85(1), pp.81-86.
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Hackney, J.M., Hunt, G., Lerche, F. and Smith, J., 2010. mechanism And Effectiveness Of An External Shoe Modification In Reducing Metatarsalgia Symptoms: opl39. journal of Orthopaedic & Sports Physical, 40(1), pp.A27-A28.
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Hackney, J.M., Hunt, G.C., Lerche, F.F., Voi, P. and Smith, J.W., 2010. An external shoe modification for reducing metatarsal head pressure in people with metatarsalgia. JPO: Journal of Prosthetics and Orthotics, 22(1), pp.37-42.
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Menz, H.B., Lim, P.Q., Hurn, S.E., Mickle, K.J., Buldt, A.K., Cotchett, M.P., Roddy, E., Wluka, A.E., Erbas, B. and Munteanu, S.E., 2022. Footwear, foot orthoses and strengthening exercises for the non-surgical management of hallux valgus: protocol for a randomised pilot and feasibility trial. Journal of Foot and Ankle Research, 15(1), p.45.
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Mündermann, A., Nigg, B.M., Stefanyshyn, D.J. and Humble, R.N., 2002. Development of a reliable method to assess footwear comfort during running. Gait & posture, 16(1), pp.38-45.
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Myers, K.A., Long, J.T., Klein, J.P., Wertsch, J.J., Janisse, D. and Harris, G.F., 2006. Biomechanical implications of the negative heel rocker sole shoe: gait kinematics and kinetics. Gait & posture, 24(3), pp.323-330.
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Case Series / Case Studies

Drakos, M.C., Fiore, R., Murphy, C. and DiGiovanni, C.W., 2015. Plantar-plate disruptions: “the severe turf-toe injury.” three cases in contact athletes. Journal of athletic training, 50(5), pp.553-560.
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Narrative Literature Reviews

Colò, G., Fusini, F., Melato, M., De Tullio, V., Logrieco, G., Leigheb, M. and Surace, M.F., 2024. The effectiveness of shoe modifications and foot orthoses in conservative treatment of lesser toe deformities: a review of literature. Musculoskeletal surgery, pp.1-8.
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Colò, G., Leigheb, M., Surace, M.F. and Fusini, F., 2024. The efficacy of shoes modification and orthotics in hallux valgus deformity: a comprehensive review of literature. Musculoskeletal surgery, pp.1-8.
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Monteagudo, M. and Orejana, Á.M., 2024. Orthotics for the Treatment of Lesser Toe Deformities. Foot and Ankle Clinics.
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Study Protocols

Menz, H.B., Lim, P.Q., Hurn, S.E., Mickle, K.J., Buldt, A.K., Cotchett, M.P., Roddy, E., Wluka, A.E., Erbas, B. and Munteanu, S.E., 2022. Footwear, foot orthoses and strengthening exercises for the non-surgical management of hallux valgus: protocol for a randomised pilot and feasibility trial. Journal of Foot and Ankle Research, 15(1), p.45.
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Meta-Analyses

Hurn, S.E., Matthews, B.G., Munteanu, S.E. and Menz, H.B., 2022. Effectiveness of Nonsurgical Interventions for Hallux Valgus: A Systematic Review and Meta‐Analysis. Arthritis care & research, 74(10), pp.1676-1688.
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Khosravi, M., Babaee, T., Daryabor, A. and Jalali, M., 2022. Effect of knee braces and insoles on clinical outcomes of individuals with medial knee osteoarthritis: A systematic review and meta-analysis. Assistive Technology, 34(5), pp.501-517.
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Matthews, B.G., Hurn, S.E., Harding, M.P., Henry, R.A. and Ware, R.S., 2019. The effectiveness of non-surgical interventions for common plantar digital compressive neuropathy (Morton’s neuroma): a systematic review and meta-analysis. Journal of Foot and Ankle Research, 12.
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Ruiz-Ramos, M., Orejana-García, Á.M., García-Oreja, S., del Mar Calvo-Wright, M., Lázaro-Martínez, J.L. and Molines-Barroso, R.J., 2025. Effectiveness of bespoke or customised orthotic treatment in plantar pressure reduction of the central metatarsals: A systematic review and meta-analysis. Journal of Orthopaedics, 59, pp.111-118.
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Systematic Reviews

Cabrera-Sánchez, J.M., Reina-Bueno, M., Palomo-Toucedo, I.C., Vázquez-Bautista, M.D.C., Núñez-Baila, M.Á. and González-López, J.R., 2024, October. Effect of Foot Orthoses and Footwear in People with Rheumatoid Arthritis: An Updated Systematic Review. In Healthcare (Vol. 12, No. 20, p. 2017). MDPI.
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DeHeer, P.A., Patel, N.A., Wolfe, W., Badell, B., Kirkland, M. and Wallace, B., 2024. Orthoses Effect on Radiographic Measurements of Hallux Abducto Valgus: A Systematic Review. Journal of the American Podiatric Medical Association, 114(4).
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Hawke, F. and Burns, J., 2012. Brief report: custom foot orthoses for foot pain: what does the evidence say?. Foot & ankle international, 33(12), pp.1161-1163.
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Kunnasegaran, R. and Thevendran, G., 2015. Hallux Rigidus: Nonoperative Treatment and Orthotics. Foot and ankle clinics, 20(3), pp.401-412.
Click here for Article

Munteanu, S.E., Buldt, A., Lithgow, M.J., Cotchett, M., Landorf, K.B. and Menz, H.B., 2024. Non‐surgical interventions for treating osteoarthritis of the big toe joint. Cochrane Database of Systematic Reviews, (6).
Click here for Article

Robinson, A.H.N. and Limbers, J.P., 2005. Modern concepts in the treatment of hallux valgus. The Journal of bone and joint surgery. British volume, 87(8), pp.1038-1045.
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Shereff, M.J. and Baumhauer, J.F., 1998. Current Concepts Review-Hallux Rigidus and Osteoarthrosis of the First Metatarsophalangeal Joint. JBJS, 80(6), pp.898-908.
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Interventional Studies

de Oliveira, H.A.V., Natour, J., Vassalli, M., Rosenfeld, A., Jennings, F. and Jones, A., 2019. Effectiveness of customized insoles in patients with Morton’s neuroma: a randomized, controlled, double-blind clinical trial. Clinical rehabilitation, 33(12), pp.1898-1907.
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Eweis, N.A., El-Kadery, N.A.E.S., Ahmed El-Hilaly, R. and ElBadawy, M.A., 2023. Comparison between Total Contact Custom-Made Insole versus Over the Counter Insole in Rehabilitation of Rheumatoid Arthritis Patients. QJM: An International Journal of Medicine, 116(Supplement_1), pp.hcad069-681.
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Gordillo-Fernández, L.M., Ortiz-romero, M., Valero-Salas, J., Salcini-Macías, J.L., Benhamu-Benhamu, S., García-de-la-Peña, R. and Cervera-Marin, J.A., 2016. Effect by custom-made foot orthoses with added support under the first metatarso-phalangeal joint in hallux limitus patients: Improving on first metatarso-phalangeal joint extension. Prosthetics and orthotics international, 40(6), pp.668-674.
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Menz, H.B., Auhl, M., Tan, J.M., Levinger, P., Roddy, E. and Munteanu, S.E., 2016. Effectiveness of Foot Orthoses Versus Rocker‐Sole Footwear for First Metatarsophalangeal Joint Osteoarthritis: Randomized Trial. Arthritis care & research, 68(5), pp.581-589.
Click here for Article

Menz, H.B., Auhl, M., Tan, J.M., Levinger, P., Roddy, E. and Munteanu, S.E., 2016. Biomechanical effects of prefabricated foot orthoses and rocker‐sole footwear in individuals with first metatarsophalangeal joint osteoarthritis. Arthritis care & research, 68(5), pp.603-611.
Click here for Article

Menz, H.B., Auhl, M., Tan, J.M., Levinger, P., Roddy, E. and Munteanu, S.E., 2017. Predictors of response to prefabricated foot orthoses or rocker-sole footwear in individuals with first metatarsophalangeal joint osteoarthritis. BMC musculoskeletal disorders, 18(1), p.185.
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Moulodi, N., Sarrafzadeh, J., Azadinia, F., Shakourirad, A. and Jalali, M., 2025. Additional effect of neuromuscular electrical stimulation in a conservative intervention on morphology and strength of abductor hallucis muscle and correction of hallux valgus deformity: a randomized controlled trial. Physiotherapy Theory and Practice, 41(1), pp.44-53.
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Partovifar, M., Safaeepour, Z. and Cham, M.B., 2021. The effect of pre-fabricated insole on plantar pressure distribution in patients with rheumatoid arthritis. The Foot, 49, p.101832.
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Paterson, K.L., Hinman, R.S., Metcalf, B.R., McManus, F., Jones, S.E., Menz, H.B., Munteanu, S.E. and Bennell, K.L., 2022. Effect of foot orthoses vs sham insoles on first metatarsophalangeal joint osteoarthritis symptoms: a randomized controlled trial. Osteoarthritis and Cartilage.
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Observational Studies

Barr, L., Munro, N., Watters, K., McCaig, R., Richards, J. and Chapman, G.J., 2024. The effectiveness of custom hard-shell 3D-printed foot orthoses in a cohort of patients who did not respond to treatment with custom ethylene-vinyl-acetate (EVA) foot orthoses. The Foot, 61, p.102142.
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Becerro de Bengoa Vallejo, R., Gómez, R.S. and Losa Iglesias, M.E., 2016. Clinical improvement in functional hallux limitus using a cut-out orthosis. Prosthetics and orthotics international, 40(2), pp.215-223.
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Chang, B.C., Liu, D.H., Chang, J.L., Lee, S.H. and Wang, J.Y., 2014. Plantar pressure analysis of accommodative insole in older people with metatarsalgia. Gait & posture, 39(1), pp.449-454.
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Choi, J.Y., Choo, S.K., Song, T.H. and Suh, J.S., 2024. Atraumatic Sport-Related Medial Sesamoid Pain: Conservative Treatment Outcome and Magnetic Resonance Imaging Features. Clinics in Orthopedic Surgery, 16(4), p.641.
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Doty, J.F., Alvarez, R.G., Ervin, T.B., Heard, A., Gilbreath, J. and Richardson, N.S., 2015. Biomechanical evaluation of custom foot orthoses for hallux valgus deformity. The Journal of Foot and Ankle Surgery, 54(5), pp.852-855.
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Farzadi, M., Safaeepour, Z., Mousavi, M.E. and Saeedi, H., 2015. Effect of medial arch support foot orthosis on plantar pressure distribution in females with mild-to-moderate hallux valgus after one month of follow-up. Prosthetics and orthotics international, 39(2), pp.134-139.
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Golden, D., Corbett, R.O., Cooper, M.T. and Hertel, J., 2024. Plantar pressure analysis of different orthoses in patients after first metatarsophalangeal joint arthrodesis. Prosthetics and Orthotics International, 48(5), pp.540-545.
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Jerilyn, T.X., Menz, H.B., Murley, G.S. and Munteanu, S.E., 2016. Effectiveness of shoe stiffening inserts for first metatarsophalangeal joint osteoarthritis: a proof-of-concept study. American journal of physical medicine & rehabilitation, 95(2), pp.103-111.
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Männikkö, K. and Sahlman, J., 2017. The Effect of Metatarsal Padding on Pain and Functional Ability in Metatarsalgia. Scandinavian Journal of Surgery, 106(4), pp.332-337.
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Martinez-Rico, M., Gijon-Nogueron, G., Ortega-Avila, A.B., Roche-Seruendo, L.E., Climent-Pedrosa, A., Deschamps, K. and Sanchis-Sales, E., 2025. Effect of different custom-made foot orthotics on foot joint stiffness in individuals with structural hallux limitus: A quasi-experimental study. Clinical Biomechanics, 122, p.106423.
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Martinez-Rico, M., Gijon-Nogueron, G., Ortega-Avila, A.B., Roche-Seruendo, L.E., Climent-Pedrosa, A., Sanchis-Sales, E. and Deschamps, K., 2024. Effect of Custom-Made Foot Orthotics on Multi-Segment Foot Kinematics and Kinetics in Individuals with Structural Hallux Limitus. Sensors, 24(19), p.6430.
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Meardon, S.A., Edwards, W.B., Ward, E. and Derrick, T.R., 2009. Effects of custom and semi-custom foot orthotics on second metatarsal bone strain during dynamic gait simulation. Foot & ankle international, 30(10), pp.998-1004.
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Mündermann, A., Nigg, B.M., Stefanyshyn, D.J. and Humble, R.N., 2002. Development of a reliable method to assess footwear comfort during running. Gait & posture, 16(1), pp.38-45.
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Peck, C.N., Macleod, A. and Barrie, J., 2012. Lesser metatarsophalangeal instability: presentation, management, and outcomes. Foot & ankle international, 33(7), pp.565-570.
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Rodríguez-Sanz, J., Roche-Seruendo, L.E., López-de-Celis, C., Canet-Vintró, M., Ordoyo-Martin, J., Fernández-Gibello, A., Labata-Lezaun, N. and Pérez-Bellmunt, A., 2024. Effects of plantar fascia release and the use of foot orthoses affect biomechanics of the medial longitudinal arch of the foot. A cadaveric study. American Journal of Physical Medicine & Rehabilitation, pp.10-1097.
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Welsh, B.J., Redmond, A.C., Chockalingam, N. and Keenan, A.M., 2010. A case-series study to explore the efficacy of foot orthoses in treating first metatarsophalangeal joint pain. Journal of foot and ankle research, 3(1), p.17.
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Case Series / Case Studies

Williams, T.H., Pasapula, C. and Robinson, A.H., 2009. Complete sesamoid agenesis: a rare cause of first ray metatarsalgia. Foot & ankle international, 30(5), pp.465-467.
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Narrative Literature Reviews

Colò, G., Fusini, F., Melato, M., De Tullio, V., Logrieco, G., Leigheb, M. and Surace, M.F., 2024. The effectiveness of shoe modifications and foot orthoses in conservative treatment of lesser toe deformities: a review of literature. Musculoskeletal surgery, pp.1-8.
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Colò, G., Leigheb, M., Surace, M.F. and Fusini, F., 2024. The efficacy of shoes modification and orthotics in hallux valgus deformity: a comprehensive review of literature. Musculoskeletal surgery, pp.1-8.
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Monteagudo, M. and Orejana, Á.M., 2024. Orthotics for the Treatment of Lesser Toe Deformities. Foot and Ankle Clinics.
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Study Protocols

Menz, H.B., Lim, P.Q., Hurn, S.E., Mickle, K.J., Buldt, A.K., Cotchett, M.P., Roddy, E., Wluka, A.E., Erbas, B. and Munteanu, S.E., 2022. Footwear, foot orthoses and strengthening exercises for the non-surgical management of hallux valgus: protocol for a randomised pilot and feasibility trial. Journal of Foot and Ankle Research, 15(1), p.45.
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Meta-analyses

Ying, J., Xu, Y., István, B. and Ren, F., 2021. Adjusted indirect and mixed comparisons of conservative treatments for hallux valgus: a systematic review and network meta-analysis. International Journal of Environmental Research and Public Health, 18(7), p.3841.
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Systematic Reviews

DeHeer, P.A., Patel, N.A., Wolfe, W., Badell, B., Kirkland, M. and Wallace, B., 2024. Orthoses Effect on Radiographic Measurements of Hallux Abducto Valgus: A Systematic Review. Journal of the American Podiatric Medical Association, 114(4).
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Interventional Studies

Chen, C.S., Chang, Y.S., Lin, K.W., Chien, M.J. and Wang, C.S., 2024. Biomechanical evaluation of 3D-printed joint-type orthosis for hallux valgus. Journal of the Chinese Medical Association, 87(8), pp.809-814.
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Plaass, C., Karch, A., Koch, A., Wiederhoeft, V., Ettinger, S., Claassen, L., Daniilidis, K., Yao, D. and Stukenborg-Colsman, C., 2020. Short term results of dynamic splinting for hallux valgus—A prospective randomized study. Foot and Ankle Surgery, 26(2), pp.146-150.
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Meta-analyses

Hurn, S.E., Matthews, B.G., Munteanu, S.E. and Menz, H.B., 2022. Effectiveness of Nonsurgical Interventions for Hallux Valgus: A Systematic Review and Meta‐Analysis. Arthritis care & research, 74(10), pp.1676-1688.
Click here for Article

Observational Studies 

Choi, J.Y., Choo, S.K., Song, T.H. and Suh, J.S., 2024. Atraumatic Sport-Related Medial Sesamoid Pain: Conservative Treatment Outcome and Magnetic Resonance Imaging Features. Clinics in Orthopedic Surgery, 16(4), p.641.
Click here for Article