Flatfoot Correction

Foot & Ankle Information Sites:

FootPhysicians.com: An excellent web site run by the American College of Foot & Ankle Surgeons for patients. There are pod casts on various foot problems as well as other useful information. Dr. Mary Crawford was the first female president of this organization in March 2009.

Clinical Practice Guidelines: From American College of Foot & Ankle Surgeons on bunions, flatfoot, and diabetic foot. Technical language is used but treatment pathways are outlines and documents are well illustrated.

Textbook of Hallux Valgus and Forefoot Surgery: This is a 500 page textbook on foot surgery that is available on line on PDF files. This has technical language but can provide some useful insights to bunion and other forefoot surgery.

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Adult-acquired flatfoot or posterior tibial tendon dysfunction usually leads to a gradual loss of the arch. The posterior tibial muscle is a deep muscle in the back of the calf and has a long tendon that extends from above the ankle and attaches into several sites around the arch of the foot. The muscle acts like a stirrup on the inside of the foot to help support the arch. The posterior tibial muscle stabilizes the arch and creates a rigid platform for walking and running. If the posterior tibial tendon becomes damaged or tears, the arch loses its stability and as a result, collapses, causing a flatfoot.

Surgery is often performed to give the patient a more functional and stable foot. Several procedures may be required to correct a flatfoot deformity, depending on the severity of the problem. These may include:

  • Tenosynovectomy—a procedure to clean away (debridement) and remove any of the inflamed tissue around the tendon.
  • Osteotomy—removal of a portion of the heel bone (calcaneus) to move the foot structure back into alignment.
  • Tendon Transfer—in which replacement fibers from another tendon are inserted to help repair damage.
  • Lateral Column Lengthening—A procedure that implants a small piece of bone, usually removed from the hip, outside of the heel bone to create the proper bone alignment and rebuild the arch.
  • Arthrodesis—Fusing of one or more bones together to eliminate any joint movement, which stabilizes the foot and prevents any further deterioration or damage.