INTRODUCTION: After reconstructive forefoot surgery, patients require complete or partial forefoot relief, which can be obtained with a variety of shoe designs.

AIM: to review our experience with the use of the heel bearing shoes for forefoot weight relief and evaluate its use & application in our daily forefoot surgical practice

METHOD: A retrospective review of all (341) patients who underwent reconstructive forefoot surgery in our unit during the period of January 2003 to October 2007.

RESULTS: All patients used Barouk heel bearing shoes in the post operative period 283(83%) were females and 58(17%) were males. Average age was 56 years (range 14–84). In March 2006 we changed our postoperative protocol with the introduction of early physiotherapy for the lesser toes. 258 procedures performed between January 2003 to February 2006 (first group), while 83 procedures performed March 2006 to October 2007 (second group).

51(19.77%) from the first group reported stiffness of toes at 6 weeks review whilst only 3(3.61%) out of the second group.18 (6.98%) reported discomfort and stiffness of the hip from the first group in comparison to only 2(2.25%) patients in group two. From the first group 27(10.47%) reported knee stiffness while only one patient in the second group. The incidence of clinically significant low back pain was 12(4.65%) in the first group and 5(5.61%) patients in the second group.

CONCLUSION: heel weight bearing shoes play an important role following reconstructive forefoot surgery; however some problems may be encountered during their use. Early physiotherapy is essential to avoid these problems.