Child Orthopedics

Frequently Asked Questions

My four-year-old son has a hemiplegic type of cerebral palsy. He's up and walking but he has a foot that's stuck in a position with a very high arch. The foot is always in a pointed toe position, too. He's going o have surgery to correct this probem. What kind of results can we expect?

Cerebral palsy is a neurologic disorder that can be present at birth or develop as a result of a birth injury. Hemiplegia refers to the fact that only one side of the body is affected.

The foot position you describe may be referred to as a clubfoot. Clubfoot describes a curved position of the foot with toes pointed down. At the same time, there is a second condition called pes cavus. Pes refers to the foot and cavus describes a very high arch.

Surgery to correct these types of problems may be needed when pain, pressure ulcers, and loss of foot contact with the floor occur. A good result after surgery and recovery would be at least 75 per cent of the bottom of the foot making contact with the floor when in the standing position. There should be no pain and no abnormal areas of pressure.

After the operation, your son may need a special (adapted) or customized shoe. The goal is to provide pain free motion needed to walk and play. Additional surgery may be needed later if structural changes occur as a result of growth.

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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