Flat Foot Reconstruction
A flat foot can be normal, or pathological. If the deformity causes pain, limits function, but the foot is supple so that the deformity is correctable, surgery to improve the foot shape (flexible flat foot reconstruction) can be helpful.
Why have the surgery?
A flat foot changes the weight bearing axis of the foot, and reduces the ability for the foot to stiffen during the toe-off phase of walking. This means more energy is needed to walk and causes fatigue, pain and dysfunction. Surgery to correct the foot shape can lessen these problems.
How is surgery performed?
The operation is typically performed under a general anaesthetic. The type of surgery will vary according to aetiology and severity of deformity. Multiple incisions are typically needed to access the various soft tissues, bones and joints. The various components of the operation can include: - Tendon lengthening - Tendon transfer, which means using a functioning muscle to provide an alternative movement to that which it may originally intended to do - Osteotomy, which means cutting a bone and reorientating it. The most common osteotomy is performed to the heel bone to change it from pointing outwards to pointing inwards.
What are the benefits?
Correcting the foot shape and balancing the soft-tissues can reduce and redistribute the forces going through the foot. This in turn can make standing, walking and wearing shoes more comfortable.
What are the risks?
All operations have risks, but the commonest and most concerning for this surgery are: - Recurrence, meaning that the deformity comes back since the repaired tissues stretch out over time. - Arthritis occurring in the surrounding joints, since the stiffness at the ankle joint can place extra stress on the other mobile joints and leads to them wearing out over time. - Blood clots, which can form in the leg and travel up to the lung where they can be fatal. This list is not exhaustive and Mr Patel can talk you through them all in more detail during a consultation.
What recovery is involved?
The recovery is dependent upon the cause and severity of the deformity, which in turn dictates how simple or extensive surgery needs to be. Patients will spend six weeks in plaster, but a pneumatic walking boot is also used for up to a further six weeks. Physiotherapy is then needed to restore strength and balance with full recovery taking up to one year.
Any other considerations?
It is not always possible to undertake a flexible correction if the foot has arthritis or has become very stiff. In that case, fusion of some joints may also be necessary.