Flat feet are a common condition. In infants and toddlers, the longitudinal arch is not developed and flat feet are normal. Most feet are flexible and an arch appears when the person stands on his or her toes. The arch develops in childhood, and by adulthood most people have developed normal arches.
Most flat feet usually do not cause pain or other problems. Flat feet may be associated with pronation, a leaning inward of the ankle bones toward the center line. Shoes of children who pronate, when placed side by side, will lean toward each other (after they have been worn long enough for the foot position to remodel their shape).
Foot pain, ankle pain or lower leg pain, especially in children, may be a result of flat feet and should be evaluated.
Painful progressive flatfoot, otherwise known as Tibialis Posterior Tendonitis, is caused by inflammation of the tendon of the tibialis posterior. The tendon then becomes inflamed, stretched or suffers a partial or total tear. If left untreated, this condition may lead to severe disability and chronic pain. Some people are predisposed to this condition if they have flatfeet or an abnormal attachment of the tendon to the bones in the midfoot.
Nonsteroidal anti-inflammatory medications, ice, physical therapy, supportive taping and bracing, or orthotic devices are the common ways of treating painful progressive flatfoot. Contact your physician before taking any medication. In some cases, a surgical operation may need to be performed to repair the torn or damaged tendon and restore normal function. To prevent reinjury, orthotic devices may be recommended. In severe cases, surgery on the midfoot bones may be necessary to treat the associated flatfoot condition.
Flatfoot surgery (arthroresis) is blocking the motion within a joint. Most commonly the subtalar joint is blocked by placing a large screw-like object into the joint. This procedure which is very common in children with flat feet have gain popularity in adults with similar conditions. Arthroresis is an out patient procedure that limits pronation and not supination.
A small incision is placed on the lateral aspect of the foot and a motion limiting implant is place between the calcaneus and the talus. The procedure usually takes about twenty to thirty minutes to perform. The procedure is very successful in correcting certain types to flatfoot deformities. Possible complications include implant failure, joint stiffness, pain, and swelling.
Recovery for arthroresis is about four to six weeks. Weight bearing is often allowed shortly after surgery. Weight bearing is done with the use of protective boots or braces. Physical therapy is used to increase strength and mobility post operatively.
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