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Flat foot surgery is a medical procedure done to correct a condition in which a person's foot does not have an arch. There are many causes of flat feet, so the type of flat foot surgery that a person needs will depend on his or her condition's specific cause. Flat foot surgery often includes implanting a joint-limiting device, repairing a stretched or torn tendon, lengthening a tendon, cutting and reshaping bones to create an arch and fusing together bones in the foot or ankle.
When a deformity causes the foot to roll excessively inward as the person walks, the implantation of a joint-limiting device might be done. This is a relatively non-invasive outpatient procedure that takes about 30 minutes to perform, because it does not require tampering with cartilage or bone. The implant is inserted into the rear of the foot and acts to stabilize the area. The patient will be on crutches for a minimum of two weeks, must wear custom braces in his or her shoes and might take a total of six weeks to fully recover. Improvements from this procedure can continue for at least one to two years after surgery.
If the tendon that supports the foot’s arch becomes damaged, torn or overstretched, multiple surgical procedures might be warranted. Tenosynovectomy is a procedure that both cleans and removes the damaged tissue surrounding the tendon. If there is misalignment of the tendon, then an osteotomy might be performed, which re-aligns the heel bone. This might involve removal of part of the bone. In addition, the patient might need a tendon transfer, during which pieces of tendons from the toes are taken to aid in repairing the damaged foot tendon.
Surgery to reshape bone and create a new arch in the foot also might be necessary. This procedure is called lateral column lengthening, and it involves the removal of a small piece of the patient’s hip bone to be integrated into the foot. If bone fusion is necessary, there will be a decrease in the range of motion of the foot, and it will take at least three to four months for the fusion to solidify. After it has solidified, it might take an additional year before the new fusion is fully healed and integrated into the foot structure.
The length of recovery after flat foot surgery will depend on the extent of invasiveness of the surgery. Although the majority of patients who undergo flat foot surgery experience significant pain relief and the ability to enjoy a more active lifestyle, there are some individuals who continue to experience pain following surgery. Undergoing surgery also has additional risks, such as the possibility of infection and atrophy of leg muscles because of their lack of use during the recovery period. Sometimes, additional surgeries are warranted as well, prolonging the recovery period and increasing the possibility of infection.
Conservative treatment options are always considered before flat foot surgery, because of the invasiveness of the surgery and the long recovery period afterward. Examples of flat foot surgery alternatives include orthotic insoles, special shoes, stretching exercises, taping of the feet and the use of braces. These treatment options are effective in most cases, leaving flat foot surgery as the recommended option in only the most severe cases.