Flat Foot Corrective Surgery
Expert Care for Flat Foot Correction
Flat feet or “pes planus” is a condition where your arches are lower than normal, sometimes they can even be completely collapsed. The cause of a flat foot is primarily due to genetic factors but can also arise from tendon weakness/injury, overuse, obesity, injury or pregnancy.
People born with flat feet may never develop symptoms, however some may complain of arch fatigue and arch pain after long periods of standing or walking. A complaint of not being able to fit into most shoes and outwards twisting of the foot if often expressed by the patient.
Most patients with flat feet will never need surgery. Flat feet are successfully treated with orthotics, supportive shoe gear, physical therapy, and weight management.
Posterior Tibial Tendon Dysfunction or “PTTD” is a common cause for what is known as an Adult Acquired Flat Foot. Simply, this means that you were not born with the flat foot, it was caused later on by dysfunction of a tendon known as the Posterior Tibial tendon which helps support the arch. When this tendon becomes inflamed, stretched and torn it is unable to support your arch properly, therefore your arch collapses.
When to consider surgery?
For those with debilitating pain caused by flat feet, surgery may be considered. Most patients have failed and exhausted all forms of conservative therapy at this stage.
If your flat feet are flexible without any signs of arthritis your surgeon will perform osteotomies in multiple foot bones, typically in the heel bone and medial column foot bones. These bone cuts help realign different joints and recreate a proper foot arch. Additional tendon procedures are also performed to aid in the correction of the flat foot. The most common one being known as a Flexor digitorum brevis tendon transfer which is a tendon that neighbors the diseased Posterior tibial tendon. By transferring this tendon we can once again help support the arch with a healthy tendon.
For those who have a more advanced condition and who have developed arthritis caused by long standing flat foot deformity the procedure of choice is known as a Triple Arthrodesis. In this procedure the surgeon will fuse two or three joints that are arthritic to relieve pain. This procedure can correct misalignments of the foot caused by the flat feet and relieve the arthritic pain. A lengthening of your Achilles tendon is performed in conjunction.