Flatfoot Reconstructive Surgery at Alliance Orthopedics
Flatfoot reconstruction surgery aims to repair the foot’s ligaments and tendons and correct deformities of the bones to restore and support the arch. These adjustments can help reduce the patient’s pain and allow them to resume an active lifestyle.
What is a Flatfoot?
Flatfoot is a term used to describe a collapsed arch, meaning your feet lay flat against the floor when standing. There are two types of flat feet:
- Rigid flat foot: remains in a fixed flat position due to damage in the joints or other abnormalities.
- Flexible flat foot: when the foot becomes flat when you walk or stand but remains normal when pressure is not applied.
Causes and Surgical Treatment for Flat Feet
Flat feet may be congenital, meaning they were present at birth, or they can be acquired over time. Since there are several causes of a flattened arch, the types of flatfoot reconstructive surgery vary depending on the root of the condition.
Posterior Tibial Tendon Dysfunction
Posterior tibial tendon dysfunction is a condition in which the tendon that connects the calf muscle to the inner foot becomes torn or inflamed. When the tendon is unable to support the foot’s arch, it tends to lead to a flat foot. To treat this condition, Alliance Orthopedics offers the following reconstructive surgeries:
- Gastrocnemius recession: lengthens the calf muscles and tendons in the back of the leg, enabling the heel to shift downward.
- Tenosynovectomy: used in less severe cases of posterior tibial tendon dysfunction before the arch has entirely collapsed, while the tendon is only mildly affected. This procedure removes the inflamed portions of the tissue from the remaining healthy tendon.
- Osteotomy: consists of cutting and reconstructing foot bones to rebuild the arch. Typically, a bone graft is used to fuse bones or lengthen the outside of the foot.
- Tendon transfer: during this procedure, the diseased tendon is replaced by a healthy tendon from another area of the foot.
Rheumatoid arthritis is a chronic inflammatory disease that attacks ligaments and cartilage in the foot and ankle, often leading to flat feet. When rheumatoid arthritis causes your arches to flatten, it can be treated with the following flatfoot reconstructive surgeries:
- Fusion: when the joints in the back of the foot are fused together, it can realign the foot’s structure, eliminate arthritis, and restore the foot’s normal shape.
- Triple arthrodesis: when all three joints in the hindfoot are fused with bone graft material or instrumentation.
When ligaments in the foot become injured due to a sudden force, the joint may fall out of proper alignment. Over time, torn ligaments may no longer be able to provide support, leading to a complete collapse of the arch. Foot arch reconstructive surgeries due to injury include:
- Internal fixation: this procedure realigns the bones using screws or plates. The metal hardware used is typically removed three to five months after surgery.
- Subtalar implant: in the case of a displaced talus bone, a subtalar implant is utilized to restore the arch’s height. Tissue can grow naturally around the implant, helping to hold it in place.
Also called Charcot foot, diabetic collapse is a severe type of flatfoot that occurs as a result of nerve damage to the lower extremities. This condition can lead to deformities in the foot, which often require surgery to remove any bony prominences that arise in the region.
For stable deformities, the bony prominence is shaved away, while for unstable deformities, fusion and reposition of the bones are needed. In the case that a fracture occurs, screws and plates will supplement a fusion procedure to provide additional bone support and stability.
Flatfoot Surgery Recovery: What You Can Expect
After flatfoot reconstructive surgery, your leg will be in a cast or splint and should be kept elevated for as much as possible for the first two weeks to reduce swelling and expedite the healing process. It’s imperative not to put weight on the foot for six to eight weeks.
Once eight weeks have passed, you can gradually begin weight-bearing activities, but one of our specialists at Alliance Orthopedics will likely recommend using inserts or an ankle brace. They will also prescribe physical therapy to accelerate recovery.