Flat foot surgery, also known as flatfoot reconstruction, is a procedure aimed at correcting flatfoot deformity and alleviating associated pain and discomfort. The specifics of the surgery depend on the severity of the condition and the underlying cause. Here’s an overview of what it typically involves:
Assessment and Planning
A detailed clinical examination is undertaken and imaging (X-rays, MRI, standing CT scans) to assess the extent of deformity and the correctability of the deformity and to help plan the surgery.
Anaesthesia
The surgery is usually performed under general anaesthesia or regional anaesthesia (spinal or epidural).
Surgical Procedures
There are hundreds of operations described for the treatment of flat feet and hence you need to discuss with your surgeon which one is most appropriate for you. The types of surgery differ if you have long standing flat feet (on both sides) or a unilateral (one sided) issue that has developed more recently. The principles are as follows:
Bone Procedures
These may include osteotomies (controlled cutting and repositioning of bones) to correct alignment. Common osteotomies are the medializing calcaneal osteotomy (moving the heel bone), a medial column osteotomy (eg Cotton or reverse Cotton osteotomy to bring down the inner side of the foot and create an arch), and an Evans osteotomy (lengthening the outer side of the foot).
Soft Tissue Procedures
These may involve tendon repairs, transfers, or lengthening to balance the forces acting on the foot. For example, the posterior tibial tendon may be repaired or transferred, and the Achilles tendon may be lengthened.
Joint Fusion (Arthrodesis)
In severe cases, fusion of certain joints (such as the subtalar, talonavicular, or calcaneocuboid joints) might be necessary to provide stability and correct alignment.
Implants
Occasionally, implants or screws might be used to support the bone corrections and ensure proper healing. An Arthroressis screw or implant is sometimes used to help correct the foot position. Its use is more common in children before growth has halted and less common in adults. If it is used in adults it is never used alone and always its an adjunct to one or more of the above procedures.
Postoperative Care
– Initial immobilization in a cast or boot to allow healing, often for 6-8 weeks.
– Gradual weight-bearing as advised by the surgeon, typically beginning with partial weight-bearing and progressing to full weight-bearing over several weeks.
– Physiotherapy to restore strength, flexibility, and function.
Recovery
Full recovery can take several months, during which the patient might need to follow a strict rehabilitation protocol to ensure optimal outcomes.
The goal of flat foot surgery is to create a more functional and pain-free foot by restoring normal alignment and biomechanics. The specific combination of procedures will vary based on individual patient needs and the surgeon’s assessment.