Biomechanical evaluation of orthotic insole design features for pediatric flexible flatfoot using finite element analysis

This study proposes a finite element (FE) framework to quantitatively evaluate customized insole designs for pediatric flexible flatfoot. Validated subject-specific FE models from nine pediatric cases were analyzed under static weight-bearing to assess the effects of arch support height, arch support area, and medial heel wedge height on plantar loading. Results revealed that arch support height and medial heel wedge height dominantly influence load transfer, with arch height facilitating midfoot loading and the heel wedge correcting hindfoot mechanics, whereas arch support area has limited impact. This quantitative approach demonstrates the potential of FE analysis to guide patient-specific orthotic prescriptions.