Arcuate foot - DRHC Dubai Pediatric Orthopedic Clinic

High arch foot can be seen in both pediatric and adult populations. Muscle imbalances (weak tibialis anterior and peroneus brevis) cause this deformity to progress over time. There is elevated medial arch and tight calf muscles which lead to contracture planter fascia. Often bilateral, and there is hereditary or congenital form.

Causes:

• Mainly neurologic conditions (poliomyelitis, Cerebral palsy , tethered spinal cord , spinal cord tumor, Charcot-Marie-Tooth (CMT) disease)
• Traumatic conditions (compartment syndrome or crush injury in the lower limb or foot fractures).
• Idiopathic: unknown.
• Patients can present with lateral foot pain from increased weightbearing on the lateral foot and recurrent ankle sprains from peroneal tendon pathology, and painful calluses under 1st and 5th metatarsal heads.
• Symptom severity is variable.

• If there is a new onset of unilateral arcuate foot we should exclude a spinal cord tumor.
• In DRHC we use weight bearing x-ray and Electrodiagnostic Studies (EMG/NCS) and magnetic resonance imaging to complete the diagnosis.

How we treat: 

• We do Physiotherapy to stretch tight calf muscles and planter fascia  and strengthen weak muscles that may relief symptoms .
• Shoe insole ( semi-rigid full length insole orthotic with a depression for the first metatarsal and a lateral side wedge).
• Making  shoe extra-depth may alleviate symptoms by  offloading bony prominences and the lateral wedge sole modification can improve function of the ankle.
•  Ankle foot orthosis (AFO) may help if there is some loss of ankle upward movement.
• Failure to maintain an asymptomatic plantigrade foot is an indication for surgery.

Surgery

• Soft tissue reconstruction: plantar fascia release, tendon transfer, lengthening of Achilles tendon, lateral ankle ligament reconstruction.
• Bone procedures: Osteotomy of the calcaneus and/or the 1st metatarsal .
• Triple arthrodesis: Indicated when there is severe  arthritic changes in the hind foot joints or when there is complete muscle paralysis.
• Tendon transfers and osteotomies and Plantar fascia release in the early stages can provide good  correction of the deformity and  minimizing the need for joints  arthrodesis

If you are in search of the best pediatric orthopedic surgeon in Dubai or children's orthopedic specialist in Dubai, then DRHC Orthopedic Clinic in Dubai offers you the top pediatric orthopedic surgeons with vast years of experience. To book an appointment call +97142798200.