The adult flat foot

After the operation

On the Day
Pain relief
After the anaesthetic has worn off your foot should be largely free of pain ,due to the use of nerve blocks(Femoral and Sciatic) . You will be given a course of pain killers and anti inflammatory tablets .These will be working for you when the nerve blocks wear off by 12 hours or so .
You may also require a PCA analgesic pump.

Your foot
Immediately after the operation you will have a temporary plaster cast. The day following this will be changed into a lightweight fibreglass cast.

Mobility
A physiotherapist will instruct you on the use of crutches the day following surgery. You will be non weight bearing on the operated foot for a period of six weeks.

Length of stay
One or two post-operative days depending upon comfort and mobility.

DVT prophylaxis
Aspirin 150mgs for 6 weeks.

At two weeks
You will require an outpatient assessment and wound review. Self absorbing sutures are normally used .Your lightweight cast will be changed and non weight bearing will continue for another four weeks.

At six weeks
You will require an outpatient assessment and check X Ray to confirm satisfactory progression of the fusion.
You are likely to be advised to increase your weight bearing through the cast as symptoms dictate and gradually cease using crutches.

At twelve weeks
Your cast will be removed and a final X-ray taken .
You may now return to normal shoe wear and activities a able.

Results

Early
The position of your foot will be much improved. It is likely that your function will be improved and there will be a significant reduction in your pain.
There is a small chance of one of the joints not fusing. This will either be the Calcaneo-cuboid or the Talo-Navicular . This is likely not to give a problem.

Intermediate
By 5 to 10 years there is a high chance of developing arthritic change in the neighbouring ankle and remaining midfoot joints. The reason for this is ,as with ankle fusion ,the stresses through the remaining joints are increased.
It is likely that the effect of this upon you will be minimal.

Late
By 20 to 30 years