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Flatfoot deformity is a condition where the instep of the foot comes in contact with the ground, or flat, when standing. This may occur as a child because the arches fail to form or as an adult when the arches flatten due to:

  • A tendon injury
  • Arthritis near the heel
  • Rheumatoid arthritis
  • Posterior tibial tendon dysfunction
  • Progressive (adult) pes planus
  • Fallen arches

How Are Flat Feet Diagnosed?

An orthopaedic surgeon will perform a physical exam and ask questions regarding symptoms to determine the type of flatfoot condition. During this exam, the surgeon may ask you to stand on your toes. If an arch forms, your flatfoot is considered flexible, and no treatment is usually needed. However, if this does not happen, your flatfoot is considered rigid. A rigid flatfoot may require flatfoot reconstruction. 

Although, if flexible flat feet are causing foot pain, the surgeon may order an imaging test such as an X-ray so he or she can better determine what might be causing the pain.

When to Consider Flatfoot Reconstruction Surgery                 

Before scheduling flatfoot reconstruction, the orthopaedic surgeon may recommend nonsurgical treatments first, such as cushioned arch supports, shoe inserts (orthotics), weight loss, or physical therapy; however, if these nonsurgical treatment options prove to be unsuccessful, the doctor may recommend surgery. 

Flatfoot reconstruction is a surgical procedure commonly recommended and performed by an orthopaedic surgeon to correct this condition, improve foot alignment, create an arch in the foot, and reduce or eliminate pain. This procedure is often performed in the hospital using general anesthesia. During surgery, the orthopaedic surgeon will make several incisions in the foot in order to remove the damaged instep tendon and replace it with another tendon. This phase of the surgery is called tibialis posterior tendon reconstruction.

Next, a second procedure is performed to reposition or lengthen the bone. To do this, the orthopaedic surgeon will make an incision in the heel bone, reposition or lengthen it, then secure it with a metal screw. The surgeon may also then insert a metal plate at the top of the foot to help increase the arch of the foot. This second procedure is called calcaneal osteotomy or calcaneal lengthening osteotomy.

Following the procedure, patients will go to a recovery room to be monitored while the anesthesia wears off. The foot would then be placed into a cast and elevated. In most cases, this surgery requires an overnight stay in the hospital.

What to Expect After Flatfoot Reconstruction Surgery

After flatfoot reconstruction, most people can return to normal activity within several months; however, for several weeks, patients will use crutches and avoid weight bearing on the foot. After approximately two to three months, patients are able to wear their own shoes and return to walking normally. During this time, patients are recommended to complete exercises to help reduce muscle tightness and swelling as part of the healing process. The orthopaedic surgeon may also recommend physical therapy.

Learn About Our Foot & Ankle Center at Tidewater Orthopaedics

Our Foot & Ankle Center is designed to provide comprehensive education and exceptional surgical care through the knowledge, experience, and expertise of our specialty-trained foot and ankle surgeon, Dr. Paul Maloof. He aims to treat his patients in the most conservative manner, reserving surgery only for cases when nonsurgical management is no longer an option. Dr. Maloof brings many advanced treatments to Tidewater Orthopaedics as the only full-time foot and ankle orthopaedic surgeon in the region specializing in complex and comprehensive foot and ankle care, both surgical and nonsurgical. Dr. Maloof treats a wide range of injuries and conditions, including flexible flatfoot and rigid flat feet. To search the full list of injuries, conditions, and procedures he specializes in, click here

Why choose Tidewater Orthopaedics?

If you are considering treatment, you should seek out an orthopaedist with experience and training in foot deformities such as flat feet. With years of experience and advanced training, our esteemed foot and ankle surgeon at Tidewater Orthopaedics, Dr. Paul Maloof, is the unparalleled expert in accurately diagnosing and effectively treating foot injuries and conditions.
Dr. Paul Maloof has the knowledge, proficiency, and skill to accurately diagnose and effectively treat you so you can get back to your active lifestyle quickly and safely.

To consult with our Tidewater Orthopaedics surgeon, please request an appointment online or call (757) 827-2480. We have two convenient locations, Hampton and Williamsburg, to best accommodate your needs.