Child Orthopedics

Frequently Asked Questions

Our 12-year-old daughter has a really high arch in both feet. I thought she might outgrow this, but it seems to be getting worse instead of better. What (if anything) can be done about this?

The medical term for a very high arch in the foot is pes cavus. Sometimes this is just a mild deformity with no known cause. In other cases, there may be an underlying neuromuscular condition. For example, children with cerebral palsy, polio, or arthrogryposis fall into this category.

Treatment isn't always necessary with this condition. When the foot position causes calluses, pain, or pressure ulcers, then it becomes a problem. The first step is to have a medical exam by a qualified specialist. Your primary care physician may refer you to a podiatrist or an orthopedic surgeon.

Surgery to correct the alignment of the bones may be needed. But it's likely that other more conservative care may be advised first. For example, shoe inserts called orthotics may be helpful. A prefab insert may be used on a trial basis. If these work well enough, then a custom made orthotic may be made.

If surgery is needed, there are a variety of procedures to treat this problem. Releasing some of the soft tissues and/or using a wedge of bone to change the position of the forefoot and arch may be recommended. A tendon transfer or lengthening may be done to correct any muscular imbalance.

Dennis S. Weiner, MD, et al. The Akron Dome Midfoot Osteotomy as a Salvage Procedure for the Treatment of Rigid Pes Cavus. In Journal of Pediatric Orthopaedics. January/February 2008. Vol. 28. No. 1. Pp. 68-80.

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