
Pes planus is also known as flat foot
- Loss of the medial longitudinal arch of the foot
- Heel valgus deformity
- Medial talar prominence
The deformity is usually asymptomatic and resolves spontaneously in the first decade of life, or occasionally progresses into a painful rigid form which causes significant disability.
It has 2 forms. When the arch of the foot is intact on heel elevation and non-bearing but disappears on full standing on the foot, it is termed FLEXIBLE FLATFOOT while RIGID FLATFOOT is when the arch is not present in both heel elevation and weight bearing.
The most common etiology of the adult acquitted flatfoot is Posterior Tibial Tendon Dysfunction (PTTD)

Surgical Procedures:

Flatfoot correction (flexible deformity): osteotomy with tendon transfer
A flatfoot deformity that remains flexible can be corrected through a series of bony osteotomies and tendon transfers to centre the heel, return the Achilles tendon to it’s normal line of pull of the Achilles tendon, relieve impingement and inflammatory pain, as well as restore the medial arch.
Flatfoot correction(rigid deformity):

Flat Foot Reconstruction Surgery
Post Operative Instructions
Cast:
- You will have a dressing on your foot for 2 weeks following surgery
- A post op aircast will be then worn for 4-6 weeks
- At 6 weeks, you will wean off the air cast and begin walking in a regular shoe
Wound:
- The surgical incision has been closed with sutures
- Do not get the dressing or wound wet for the first two weeks.
- When showering place a bag over the dressing and secure with tape to your leg to avoid the cast and wound getting wet
- Stitches will be removed at your 2 week appointment
- After the stitches are removed, you may begin to shower after 2-3 days
- Do not immerse the foot in water (bath, hot tub, pool) for 6 weeks
- Do not apply any lotions or creams on the wound for 6 weeks
Weight Bearing:
- You will be non weight bearing for the first 2 weeks while in a splint
- You will use a mobility device to offload your foot (crutches, walker, stirrup cast)
- You wiill begin weight bearing at 4-6 weeks post op depending on wound healing
Medications:
- Pain medication should be used regularly for the first 24-48 hours, when required for the first 1 to 2 weeks, followed by Regular Tylenol
Driving:
- For right foot surgery you are not permitted to drive until you have completely weaned off the boot
- For left foot surgery, please contact your insurance company to see if you are permitted to drive
- Driving is not permitted while on narcotics
Work:
- Four to six weeks off from work is recommended for initial recovery
- If you are able to get to work safely, and will be seated for the majority of the day, you may return to work four to six weeks after surgery. This is assuming you are not taking narcotic pain mediation.
- From 2-6weeks sedentary duties is recommended
- By 12 weeks you can gradually return to full duties
- If your job is physically demanding, return to full duties is usually possible around 12-16 weeks post operatively
Follow Up:
- You will have your first appointment 2 weeks after surgery in the Fracture Clinic
- Your next appointments will be at 6 weeks, 3 months then 6 months post operatively
- You will have x-rays taken at these appointments
Recovery:
- It is normal to experience mild to moderate pain, numbness, or tingling for the first 2 weeks following surgery
- Please come to the emergency department if you are suffering from severe pain
- You will get back to most of your activities by 6-12 months
- Swelling often remains for 6-12 months
- Residual stiffness is a normal consequence of ankle fracture
Physiotherapy:
- Six weeks after surgery you will be referred for physiotherapy (Physiotherapy protocol)