It’s no fun to be limited by flat feet pain and the accompanying limitations it can place on your life. If you have been experiencing this pain you can relate. If you have experienced severe foot pain due to flat feet/low arches, you are even more aware of the importance of getting treated. Pain that is due to flat feet will tend to worsen over time and leave you missing out on fun activities, and feeling miserable when you try to do some of the things you love. Thankfully, there are treatments available.
These can range from changing your type of shoes, all the way to reconstructive surgery. It’s important to know about the different methods of treating flat feet pain, which you can read more about here. In the following sections, we will focus on the specifics of flat feet surgery to help you be more informed.
Basically, there are 5 different types of flat feet surgeries:
Medializing Calcaneal Osteotomy
A calcaneal osteotomy is a procedure where the heel bone (calcaneal) is cut and shifted inward or outward. This is used when the heel bone has shifted out from underneath the leg and hind foot alignment is offset. After the procedure, metal screws or a plate are used to hold the heel in place. With this procedure, recovery time is at least 6 weeks of non-weight bearing in a cast or boot. After 6 weeks the patient can start applying pressure as they are able and should be wearing shoes by 8-12 weeks. Full recovery generally takes up to a year or more. Potential complications include the possibility of nerve damage, and painful hardware that may need to be removed once the bone is healed.
Lateral Column Lengthening
In this procedure, the lateral column is lengthened by inserting a bone graft. Specifically, the front of the heel bone is cut and a bone graft wedge is placed in to lengthen it. The graft can come from a cadaver or the patient’s hip bone. This is often done alongside the calcaneal osteotomy. Recovery time generally includes non-weight bearing or limited weight bearing in the heel. A patient should be able to transition into a shoe after 10-16 weeks. Full recovery can take up to 18 months.
Dorsal Opening Wedge Osteotomy
With a dorsal opening wedge osteotomy, a bone wedge is placed in the top portion of the medial cuneiform bone to push it downward. In a similar procedure, called the first tarsal metatarsal fusion, the bone is pushed down and the bones are fused into that position.
Tendon and Ligament Procedures
In these procedures, the posterior tibial tendon often requires removal if it is thickened or torn. The ligaments that support the arch may have been torn in the case of a flat foot. If significant damage has been done these structures may need to be repaired. In the case of a tightened Achilles tendon, there is a stretching procedure which lengthens the muscle fibers of the calf.
Double or Triple Arthrodesis
To surgically correct stiff and inflexible flatfoot complications with arthritis, a double or triple arthrodesis is performed. This is basically a fusion of one or more joints. These types of fusions are generally avoided by surgeons, but in severe cases they are used for treatment as a last resort. They can help improve stability in walking and may reduce pain. Recovery time generally includes 6-8 weeks of no weight bearing, and up to 18 months to fully recover. Complications could include nerve injury, or a non-union (where the joint fails to fuse together properly). Non-unions happen in about 5% of cases and may require additional surgery.
Less Invasive Titanium Stent
Another procedure that has seen success, and is less invasive, is placement of a stent. In this treatment, a small titanium stent is placed in a natural opening between the ankle and the heel bone and helps to realign the foot and can relieve foot pain. Recovery time for this type of treatment is less than traditional surgeries. If you are looking at flat feet surgery as a treatment option, you may want to consider the less invasive stent placement.
