Feb 17

Written by: Larry Huppin, DPM
2/17/2011 12:08 PM

In recent blogs I’ve mentioned the importance of orthoses conforming tight to the arch of the foot to achieve better clinical outcomes when treating many of the pathologies most commonly treated with custom orthoses. To confirm that your orthoses are conforming to the arch as they should, it is critical that you evaluate every pair of orthoses when they are dispensed to your patient.

There are several reasons why the arch of the orthosis may not conform adequately to the arch of the foot. These include

• A negative cast that was taken with the first ray dorsiflexed :
• A prescription that asks for a standard or maximum cast fill, rather than minimum
• Overfill of the medial arch by the orthotic lab

The easiest method to evaluate arch height is to place the patient’s foot into casting position with the first ray plantarflexed. Hold the orthosis to the foot. In this position the orthosis, if prescribed with a minimum fill, should conform close to the arch of the foot as shown in the picture on the left. It should not gap from the arch as shown in the picture on the right.

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