Flat foot reconstruction surgery is carried out to relieve pain and restore function in people whose foot arches are very low and where orthotics have not helped. Problems may be caused by a deformity, damage to the tendon that supports the arch or arthritis in the joints around the heel.
The procedure is usually done under a general anaesthetic with an injection in the foot to numb it and reduce pain after the operation. In most cases you will stay overnight in hospital.
During surgery, three incisions (cuts) are made in the foot and the painful, damaged tendon on the instep is removed and replaced with another tendon (the flexor digorum longus tendon or FDL). This is known as tibialis posterior tendon reconstruction.
A procedure known as calcaneal osteotomy is usually carried out at the same time; this involves making a cut in the heel bone so that it can be repositioned and fixed with a metal screw. Repositioning the heel bone helps improve support to the foot arch. The surgeon may also place a metal plate at the top of the foot to increase the arch. You will be able to discuss these procedures with your specialist beforehand.
Immediately after surgery:
During the first few weeks :
Everyone is different, so healing and post-operative programmes vary from person to person. However, the schedule of follow-up appointments below is typical:
This varies from person to person. Below is a guide, but everyone is different and you should always contact the Fortius Clinic if you are worried.
You will be referred to a physiotherapist who can design a personalised rehabilitation programme that includes gait re-education (walking correctly), and helping to reduce swelling and muscle tightness.
It’s important to keep the plaster cast totally dry. However, you will be able to shower with a waterproof cover over the plaster. Once the plaster is removed, it’s fine to shower without the cover if the wound is healed, but gently dab it dry.
Once out of cast, don’t pull at your scabs, let them fall away naturally. If your wound becomes red, swollen or sore you should contact the Fortius Clinic and arrange to see your consultant to check you don’t have an infection. Your physiotherapist may advise you about massaging the wound once it has healed.
The DVLA states it’s the responsibility of the driver to ensure they are always in control of the vehicle. A good guide is if you can stamp down hard with the foot to stop the car in an emergency stop. This will take at least eight weeks. Although your specialist will advise you about when it’s safe to start driving again, it remains your responsibility to drive safely and you should also check with your vehicle insurer to confirm you are covered.
This depends on the type of work you do and how quickly you recover. As a general guide, if your job involves sitting down for most of the time, you should be able to return to work after three weeks; if it involves manual work, you may need to have up to 12 weeks off.
Most people are able to return to a good level of activity and sports within six months and this, along with reduced swelling, should continue to improve up to a year after the procedure. You may be advised to wear insoles to help support your feet, particularly during sporting activities
Below is a guide to the risks of this type of surgery. However, your surgeon will discuss these with you before your procedure, and answer any questions you may have:
Important:This information is only a guideline to help you understand your treatment and what to expect. Everyone is different and your rehabilitation may be quicker or slower than other people’s. Please contact us for advice if you’re worried about any aspect of your health or recovery