The Foot and Ankle Clinic

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

 

What treatments are available for a painful flat foot?
ORTHOTIC MANAGEMENT
Orthotic treatment may be able to reposition a mobile flat foot and hold it in a corrected position.

flat foot
orthotic treatment - front
flat foot treatment - back

The effect is only present when the orthotic is worn in the shoe and ceases if it is not worn. Whatever the cause of the flat foot the techniques used will be essentially the same. These are to resupport the arch with a rigid plastic arch ,

orthotic
orthotic

and to reposition the heel by placing a "wedge" under its inner side to tilt it and a heel cup to hold it

flat foot withoug orthotic
flat foot with orthotic

Whether orthotic treatment prevents the progression of a deformity is not definitively known, but from basic principles there is no reason why it should not.

In the flexible flat foot orthotics are usually the recommended first line of treatment.
In a rigid and arthritic flat foot orthotics cannot correct the foot position but they may be able to improve symptoms.

OPERATIVE MANAGEMENT
The following refers to the two commonest scenarios which comprise the bulk of operative cases. These are:

  1. A flat foot due to Tibialis posterior dysfunction which an orthotic has failed to treat.
  2. The rigid and painful flat foot.
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