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Flat foot

| What is it? | Is this condition always a bad thing? | How can I tell if my foot corrects fully? (What does it mean?) | When might there be a problem? | Are there any other variants in shape? | What makes the arch? | What can cause this condition and how? | What symptoms might I get? | What treatments are available for a painful flat foot? | What happens if I leave my condition untreated? | Tibialis posterior reconstruction | Why can't the tendon simply be repaired? | The operation - operative schematics | Operative stills - a) the calcaneal osteotomy ("heel shift") | Operative stills - b) the tibialis posterior debridement and flexor digitorum transfer | After the operation | Chance of success | The stiff (non correctable) and painful arthritic flat foot | What and why? | Are there any catches? | The operation - operative stills-triple fusion | The operation - pre and post operative appearance | After the operation

 

When might there be a problem ?

  • If your foot changes to this shape having started off with an arch.
  • If you develop pain where there was none before.
  • If your foot becomes fixed in this position, wheras previously it was flexible .
  • If the flat foot is on one side only (unilateral).

right sided flat foot
A right sided flat foot, the left side normal.

Are there any other variants of foot shape?
The main other pathological foot shape is the cavo-varus or equino-cavo-varus foot.
Cavus means a high arch. Varus that the heel moves towards the midline of the body and equinus that the foot angles downwards (like a ballerina "en pointe")

carvo-varus foot
carvo-varus foot
carvo-varus foot
The cavo-varus foot

What makes the arch?
The inner arch of the foot is formed and maintained by:

  1. Bones /joints: The alignment of the bones (calcaneum ,talus ,cuboid,navicular,cuneiforms and metatarsals) and the joints which they make with each other)
  2. Muscle/tendon : The pull of the Tibialis posterior(Tib post) tendon and its balancing muscles(antagonists) the peroneals.
  3. Ligament :tight and unyielding ligaments sitting deep on the inner border of the foot (The spring ligament in particular) and the sole of the foot (the plantar ligaments).
arch
Interactive Foot and Ankle 2 (C) 2000 Primal Pictures Ltd
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