The aim of surgical correction of congenital high arched feet is to allow the foot to gain stability in standing and walking with the foot on the ground. But the high arched foot is a continuously developing deformity. The progression of the deformity is driven by the presence of neuropathies that are often not completely curable, causing imbalances in the muscular forces of the foot between adduction and abduction, and plantar flexion and dorsiflexion.
As the disease progresses, soft tissue contractures develop, transforming the high arch deformity from soft and reversible to rigid. As a result, patients who are treated orthopaedically at a young age or in adolescence are at risk of recurrence of the deformity as they age.
However, we still advocate early and aggressive intervention in the early stages of the disease, both to help the child regain as much walking function as possible before undergoing second-stage surgery in adulthood and, in some cases, to slow the progression of the disease after soft tissue surgery to adjust the muscle balance of the foot thereby avoiding the need for more invasive bony surgery.