Flat foot surgery

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What is flat foot surgery?

This surgery is designed to correct the foot’s alignment, ease any pain and ensure even weight distribution when walking or standing.

What does flat foot surgery involve?

The surgery is performed under a general anaesthetic, with a post-operative local anaesthetic administered to minimise pain. Normally it requires several procedures, notably repair of the tendons and ligaments supporting the arch and reshaping bone to renew the arch.

In a procedure called tibialis posterior tendon reconstruction, the damaged tendon on the instep is taken away and replaced by another tendon in your foot. Usually, a further procedure known as calcaneal osteotomy is also performed: this is when the surgeon makes an incision in the heel bone and refixes it with a very small metal screw and, on occasion, a metal plate is inserted too to ensure the arch of the foot is properly supported.

Attending a pre-assessment screening is good way of maximising the benefits of your surgery. At your screening, you’ll have your blood tested to assess your Vitamin D levels; swabs will be taken to check for infection or other issues; you’ll be weighed and have a chance to talk through your medical history, to highlight any potential anaesthetics issues.

It is highly recommended that you stop smoking at least eight weeks before surgery because smoking affects your ability to heal and leads to health issues, such as greater risk of pulmonary embolism (blood clots forming in the lungs) or deep vein thrombosis (blood clots in the calf).

Why might I need flat foot surgery?

If you are suffering from flat feet, a condition when little or no space exists beneath the arch of the foot when you are in a standing position, you may require flat foot surgery. Symptoms include:

  • Experiencing pain when running or walking, particularly on the inner ankle and foot
  • Ankle swelling
  • Damage to the nerves in the foot on the inside of the ankle, causing numbness or a tingling sensation

Without treatment, the foot can lose flexibility and the problem can become more harder to put right and cause arthritis, so getting an early diagnosis is key.

How long does it take to recover?

Most patients are able to leave hospital on the same day as their surgery, after being shown how to walk using crutches. After your surgery, your foot will be in a plaster cast, which will remain on for up to six weeks. You should try to rest your foot, keeping as much weight off it as possible, and keeping it raised above the level of your heart whenever you can.

It is important to refrain from taking anti-inflammatory medications or smoking: both can hinder recovery.

A week after surgery, your pain levels should be significantly reduced, and you can start to walk short distances at home with the aid of your crutches. Around five or six weeks after your operation, you can begin some physiotherapy exercises to help your recovery, improving your fitness, balance, flexibility and strength.

For more details about recovering from flat foot surgery, read our downloadable patient information leaflet.

What is the long-term impact of flat foot surgery?

While swelling in the foot may last up to a year, after six months it is generally minimal. Most patients are able to return to sports (starting with low impact ones) around six to twelve months after their operation, often with the aid of insoles to support their feet.

Flat foot surgery can minimise pain, distribute weight more evenly when you walk or stand and improve your foot’s alignment. The flexibility and strength of your foot will gradually get better, so you can return to your usual lifestyle.