Flatfoot Correction (planovalgus)

A painful flat foot that is worsening can be corrected by surgery to realign the bones and repair the failing soft tissues

One of the primary problems in these cases is the stretching of the soft tissue structures maintaining the arch of the foot. The foot flattens out over time, abnormally loading the joints and potentially causing pain and leading to arthritis.

The goal of this surgery is to re-align the foot to a more “normal” position to improve the biomechanics and hence pain.

Possible procedures for this type of foot include:

  • Achilles tendon lengthening

  • Tendon transfer of Flexor digitorum

  • Calcaneal osteotomy

  • Lateral column lengthening

  • Recreating the arch with a cotton osteotomy

  • Bunion correction

  • Medial ligament repair

Figure 1: the goals of flatfoot correction surgery are to recreate the arch, align the heel underneath the leg and correction “swinging out” of the forefoot

Figure 2: repair of the soft tissues in a flatfoot correction procedure

Post-operative plan:

  • Surgery is typically a 1-2 night stay

  • A nerve block of the leg is administered to help with pain

  • 0-2 weeks: elevation at home, plaster cast

  • 2-6 weeks: Non weight bearing in a lightweight cast or CAMboot

  • 6-10 weeks onwards: walk in moon boot

  • >12 weeks: progress to strengthening

Download post-operative care guide

 

Risks of surgery

  • Swelling, stiffness

  • Infection and wound breakdown

  • Blood clots

  • Scar sensitivity

  • Ongoing pain

  • Recurrence of deformity

  • Progression to arthritis of the foot or ankle joints

  • More surgery in the future