Flatfoot Reconstruction

Flatfoot Reconstruction

Foot reconstruction is a surgery performed to correct the structures of the foot and restore the natural functionality of the foot that has been lost due to injury or illness.

Flat foot or pes planus is a condition in which the foot does not have a normal arch when standing.

The primary objectives of flat foot reconstruction are reduction of pain and restoration of function and appearance. This can greatly benefit patients’ medical and aesthetic needs. The surgery to be performed depends on several factors such as the age of the individual, severity and duration of the symptoms.

It is often recommended when conservative treatments fail to resolve the symptoms. Debridement of the inflammation and repair of torn posterior tibial tendon tears are important to preserve the function and maintain the arch. When the tendon is severely diseased, it may require replacement by the flexor digitorum longus tendon which would be transferred to the navicular. This is usually augmented with repair of the spring ligament and medializing the calcaneal tuberosity. Shifting the heel inward decreases the demand on the posterior tibial tendon, and makes is less prone to future failure.

With more severe deformities, a lateral column lengthening, additional midfoot osteotomy or triple arthrodesis may be needed.

After the surgery

Following are the post-surgical guidelines to be followed after reconstruction:

• Make sure you get adequate rest. Avoid using the affected foot for a few weeks.
• Take medications to help alleviate pain and inflammation as prescribed by your doctor.
• Compression dressings (bandage) are used to support the foot to reduce swelling. Take care not to wrap too tightly which could constrict the blood vessels.
• Keep the foot elevated at or above the level of your heart. This helps minimize swelling and discomfort.
• A wheelchair might be required for a few days in more severe cases.
• Start rehabilitation (physical therapy) as recommended by your surgeon to improve range of motion.
• Crutches or a walker may be used to maintain balance or stability while walking. You should begin appropriate exercises to stretch and strengthen the muscles. A roll-a-bout can be rented or purchased, and also improves the ease of mobility without putting weight on the operative foot.
• Cover the splint while showering to keep it clean and dry. Cast bags can be purchased on-line or in drug stores.
• Return to sports once the foot has regained normal strength and function with your surgeon’s approval.

The outcome of flat foot reconstruction surgery is greatly improved when you, your surgeon, and the physical therapist work together as a team.

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