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Flat Foot Surgery

This surgery can help improve alignment of the foot, relieving pain and helping weight to be more evenly distributed when standing or walking.

What does surgery involve?

Carried out while you are under a general anaesthetic (with a local anaesthetic in the foot to reduce pain following the operation), surgery usually involves a combination of procedures, including repairing ligaments and tendons that support the arch and reshaping bone to restore the arch.

During surgery, the damaged tendon on the instep is removed. This is replaced with another tendon in your foot in a procedure called tibialis posterior tendon reconstruction. In most cases, another procedure called calcaneal osteotomy is also carried out. Calcaneal osteotomy is when the surgeon makes a cut in the heel bone and repositions it using a tiny metal screw and, in some cases, a metal plate is also inserted to help support the arch of the foot more effectively. You will normally be in hospital for 2-3 days.

Before surgery

You can help improve the outcome of surgery by attending a pre-assessment screening where you’ll have blood tests to check for levels of Vitamin D and swabs to rule out infection or other problems. You’ll also be weighed and have an opportunity to discuss your medical history. This is important so that any anaesthetics problems can be identified.

Please note: it’s important to stop smoking at least eight weeks before your procedure; this is because smoking can affect the body’s ability to heal and causes health problems including an increased risk of blood clots forming in the lungs (pulmonary embolism) or calf (deep vein thrombosis).

What happens after surgery?

Your foot will be numb and pain-free (from a local anaesthetic injection around the affected area). A member of our physiotherapy team will help you to stand, supported by crutches, and will give you a tailored programme of exercises to help you walk correctly in your plaster cast. In most cases, you’ll be given painkillers to take for a few days and offered a follow-up appointment with Mr Heidari.

What can I do to speed up my recovery?

Raising your foot above the level of your heart and keeping weight off the foot as much as possible during the first few days can help with recovery. Make sure you follow any advice about keeping the wound clean and dry, and carry out the exercises advised by your physiotherapist as these will help you to return to your normal activities as quickly as possible.

Please note: it’s important to avoid smoking or taking anti-inflammatory painkillers as these can slow the healing process.

When can I drive again?

The DVLA states that it’s the responsibility of the driver to ensure they are always in control of the vehicle. A good guide is when you can stamp down hard with the foot to stop the car during an emergency stop. How long this takes will vary, depending on how quickly you recover.

Although Mr Heidari will advise you about when it’s safe to start driving again, it is your own responsibility to drive safely and you should also check with your vehicle insurer to confirm you are covered.

When can I return to work?

This varies, depending on the type of work you do and the speed of your recovery. In most cases, if you have a sedentary job (sitting down most of the time), you should be able to return after around two weeks. If your job involves manual work, you may need up to four weeks off.

What is the long term outcome of surgery?

In most cases, patients return to their normal activities – including sport – within six months and continue to improve for up to a year. However, you may be advised to wear supportive insoles, especially if you play sport.

What are the risks of surgery?

  • All surgery carries risks. With this type of surgery, risks include a small chance of infection which can be treated with antibiotics
  • There is a small chance of deep vein thrombosis (DVT) following any surgery, although this is unusual following this type of surgery. However, you may be given blood-thinning medication after surgery as a precaution or if you are at higher risk. You will also be given support socks and exercises to reduce the chances of DVT
  • There is also a small chance of nerve damage which can cause temporary or permanent numbness around the toe
  • In a few cases (rarely) the toe can be under-corrected or over-corrected, which may require further surgery

You can find more information about recovering from flat foot surgery in our patient information leaflet, which can be downloaded from this website.