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Five hundred questionnaires were distributed to long- distance runners who had used, or who were using orthotic shoe inserts for symptomatic relief of lower extremity complaints. Three hundred forty-seven (69.4%) responded (males, 71%; females, 29%). The mean age of the respondents was 36 years (range, 15 to 61). The average distance run per week was 39.6 miles (range, 5 to 98). The mean duration for use of the orthotic inserts was 23 months (range, 1 to 96). The predominant (63%) type of orthotic device used was flexible. The presumed diagnoses in the population studied were excessive pronation (31.1 %), leg length discrepancy (13.5%), patellofemoral disorders (12.6%), plantar fasciitis (20.7%), Achilles tendinitis (18.5%), shin splints (7.2%), and miscellaneous (4.9%).Of the runners responding, 262 (75.5%) reported complete resolution or great improvement of their symptoms. Results of treatment with orthotic shoe inserts were independent of the diagnosis or the run ner's level of participation. A high degree of overall satisfaction was demonstrated by the finding that 90% of the runners continued to use the orthotic devices even after resolution of their symptoms. Orthotic shoe inserts were most effective in the treatment of symp toms arising from biomechanical abnormalities, such as excessive pronation or leg length discrepancy. Along with other conservative measures, orthotic shoe inserts may allow the athlete to continue participation in run ning and avoid other treatment modalities that are more costly and time consuming, and therefore less accept able to them.

A unique case of a coexistent fracture of the capitellum and trochlea is presented. The mechanism of injury and treatment options are reviewed.