Flatfoot Surgery
Dr. Michael Moharan is a podiatrist practicing in Rego Park, NY. Dr. Moharan is a medical doctor specializing in the treatment of the foot , ankle and related parts of the leg. As a podiatrist, Dr. Moharan diagnoses and treats conditions of the feet. The feet are key body parts that give a person stability, absorb shock,... more
What is flat feet and what leads to it?
Flat feet, also known as pes planus, is a common deformation of the foot. It is characterised by a flattened arch of the foot, which touches the ground when standing and walking. Most people with flat feet do not experience discomfort; however, as the deformity increases, flat feet can become very painful. Pain in the arch of the foot, muscle fatigue, heel pain, increasing deformity or ankle pain are the most common symptoms. Flat foot is not only painful, it makes it difficult to find comfortable shoes.
From an anatomical point of view, there are many main causes of flat feet. This is usually caused by excessive weakness of ligaments, but can also be the result of some diseases, such as obesity, rheumatoid arthritis, diabetes mellitus or injuries. When the supportive ligaments and tendons are excessively stretched, they cannot hold the bones in an anatomically correct position. One of the most important structures holding the foot is the tendon of the posterior tibia muscle. Its injury or violation can lead to flat feet. Other causes of the condition include equinus of the posterior foot, arthritis, neuroarthropathy and muscle imbalance.
What are the treatment options?
Flat-stopic affects several joints and requires an individual approach. Treatment can vary from a conservative option to surgery or a combination thereof. Some patients are well in amenable to conservative treatment, while others with more severe deformities require surgery.
Before considering surgery, all patients must undergo conservative treatment. This entails training patients in biomechanical support (e.g. shoe modification), home therapy (e.g. stretching and lower foot strengthening exercises) and medicines (anti-inflammatory drugs or corticosteroids). Studies show that after conservative approaches, 87% of patients do not need further surgical treatment.
The operation is indicated only if conservative treatment has been ineffective for 3 months or more. There are many surgical techniques developed for different stages of flat feet. Thus, the exact surgical intervention depends on the stage and condition of deformation.
What is flat feet surgery?
Flat-stopes can be of varying severity. Some people have no symptoms, while others experience pain, discomfort and limited mobility. In general, the flat feet can be flexible or rigid. With flexible deformation, the arch is visible only when the patient is standing on socks. In case of hard flat deformation of the foot, the arch is usually absent in the standing position or on the socks. There are 4 stages of foot flat feet, which determine the exact approach to treatment and surgery technique.
The first stage
The flat stop of the first stage does not require surgery and in most cases is treated conservatively.
Second stage
Third stage
The fourth stage
What does flat feet surgery include?
The operation is performed under general anaesthesia, which means that the patient is unconscious and does not feel pain. An anaesthesia is additionally injected into the foot to control the pain as soon as the general anaesthesia is over. The exact surgical approach varies from patient to patient. Before surgery, the plan of the operation is discussed, so the patient knows what to expect.
First, the surgeon makes several incisions on the foot, and then restores bones, ligaments and tendons. The two most common surgical methods are the reconstruction of the tendon of the posterior tibia muscle and osteotomy of the heel bone. During the reconstruction of the tendon of the posterior tibia muscle, the damaged tendon is replaced by a tendon graft, which is taken from another muscle, such as a long extensor of the fingers. During heel bone osteotomy, the heel bone is fixed in the correct position to provide better support for the arch of the foot. When the arch of the foot is restored, the surgeon applies stitches and plaster bandage to the knee.
Restoration and rehabilitation after surgical treatment of flat feet
In the clinic
Immediately after a small foot surgery, the patient is under close supervision of the clinic staff. The operated leg is under a plaster bandage, numb and painless. The duration of hospital stay depends on the patient's health condition. Before being discharged from the clinic, the patient is prescribed a second appointment, wound care instructions and painkillers (if necessary). Patients may expect to be able to drive again in 8 weeks or after the doctor allows them to do so.
Rest period
Active rehabilitation.
What are the long-term consequences of flat feet surgery?
Most patients return to their usual occupations and sports within 6 months after surgery. Surgical flat feet treatment improves weight distribution and foot alignment, so patients no longer experience pain and inflammation. In short, flat feet surgery improves the quality of life and allows a person to lead an active lifestyle without discomfort.
