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Eliza Shaw

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Flat foot occurs when the inner arch of the foot


Children with physiological flat foot generally do not

require any treatment. The arch forms as they grow

older ( 4 to 6 years).

Adolescents with certain types of

flat foot due to abnormal cartilage

or bony bar between the small

bones in the feet, may require

surgery to excise the

abnormal bar of tissue.

Adults with painful flat foot generally require surgery.

It is commonly due to damage to a tendon

(tibialis posterior)

Treatment depends on the stage of the disease.

Early stages are treated with pain killers and insole.

Simple repair is done for partial tear in the tendon.

Tendon transfer with heel bone displacement is done

for severely damaged tendon.

Which tendon do you use for transfer?

I use a tendon called (FDL) flexor digitorum longus

which moves the toe.

Does it affect my toe movement?

You will loose some power in the toes but that does

not affect your walking.

Why do you cut the heel bone?

The heel bone is cut and moved inwards, so that

the heel is in line with axis of the leg.

What happens after the operation?

Your leg will be in a plaster for the first 2 weeks

You will be on crutches without putting any weight

on the operated leg for 8 to 12 weeks.

You will be given pain killers to control pain.

You will also be given injections to reduce

blood clots in the leg and lungs.

It is important that you keep the leg up elevated

to reduce the swelling.

You will be seen in clinic in 2 weeks time to check the

wound and change the plaster.

You will not be able to drive until you could do an

emergency stop without any pain.

You may need 12 weeks of time off from work

depending on the nature of your job.

What are the risks of operation?

  1. Infection
  2. Nerve and arterial damage
  3. Blood clots in the legs (DVT) and lungs (PE)
  4. Non union

How will you reduce the risk of infection?

You will be given antibiotics at the time of operation.

How will you reduce the risk of blood clots?

You will be given injections to thin the