What is Flatfoot?
Flatfoot refers to the condition characterized by low foot arches. It can cause foot pain and may interfere with walking. Flatfoot occurs due to a variety of conditions including arthritis, injury, posterior tibial tendon dysfunction, and diabetes.
Procedures for Flatfoot Reconstruction
Flat foot deformity may be surgically treated by correcting any bone deformities and repairing the supporting tendons and ligaments. There are various procedures performed under local or general anesthesia. These include:
- Medializing calcaneal osteotomy: Excision of a portion of the heel bone which is then shifted to the normal anatomic position under the leg and fixed in place with a metal plate and screws.
- Lateral column lengthening: A bone wedge fixed within the outer portion of the heel bone to increase its length and prevent or correct outward rotation of the foot.
- First metatarsal fusion or medial cuneiform dorsal opening wedge osteotomy: An incision is made on the top of the foot and the bones are fused or a portion of bone is removed, and a bony wedge is placed to prevent the big toe portion from raising off the ground.
- Tendon and ligament repair or replacement: This may involve repair or removal of a damaged posterior tibial tendon or lengthening of a tight Achilles tendon. Tendons may be transferred to support the arch. Supporting ligaments are also repaired.
- Double or Triple arthrodesis: Fusion of two or three bones in the hind foot. This is usually performed in the later stages of the disease characterized by arthritis and stiff deformity.
Recovery Following Flatfoot Reconstruction
Depending on the type of surgery, you may be allowed to go home the same day or hospitalized for an overnight stay. Your leg will be immobilized in a splint or a cast and kept elevated for two weeks following which the sutures are removed. Another cast or removable boot may be placed depending on your condition. You will have to avoid weight-bearing on the operated foot for approximately 2 months and then gradually bear weight as tolerated. Your doctor may recommend physical therapy or the use of orthotics or ankle braces.
Risks and Complications Associated with Flatfoot Reconstruction
As with any surgical procedure, complications can occur and include the risk associated with anesthesia, infection, bleeding, and nerve damage. Risks specific to flatfoot reconstruction include non-union of bone, incomplete healing and break down of hardware. However, these complications are rare, and the overall success rate of flatfoot surgery is very high.