Since there are several causes of flatfoot, the types of flatfoot reconstructive surgery offered by NJ Spine and Wellness is best categorized by original condition:
Posterior tibial tendon dysfunction
This is a condition in which the tendon that connects the calf muscle to the inner foot is either torn or inflamed. Flatfoot is the primary result of this condition and can be treated by the following reconstruction surgeries:
- Gastrocnemius recession: This procedure lengthens the calf muscles, treating flatfoot and preventing it from returning.
- Tenosynovectomy: This procedure, which involves cleaning the tendon, is performed before the arch collapses and while the tendon is mildly affected. The inflamed tissue is removed from the remaining healthy tendon.
- Tendon transfer: During this procedure, the diseased tendon is replaced by tendon from another area of the foot.
- Osteotomy: This consists of cutting and reconstructing foot bones to rebuild the arch. A bone graft may be used to fuse bones or lengthen the outside of the foot.
Rheumatoid arthritis
This chronic inflammatory disease attacks ligaments and cartilage in the foot and ankle; flatfoot can be a painful side effect of this condition. It can be treated with the following flatfoot reconstruction surgeries:
- Fusion: Fusion of joints in the back of the foot can realign it, remove arthritis, and restore the foot’s normal shape.
- Triple arthrodesis: All three joints in the hindfoot are fused with bone graft material or instrumentation.
Injury
When foot ligaments are injured, the joint may fall out of proper alignment. Over time, torn ligaments will no longer be able to provide support, which can result in the complete collapse of the arch. Foot arch repair surgeries resulting from an injury include:
- Internal fixation: This involves bone realignment using metal instrumentation, such as screws or plates, which are typically removed three to five months after surgery.
- Subtalar implant: In the case of a displaced talus bone, a subtalar implant is used to restore height to the arch. Tissue can grow normally around the implant, helping to hold it in place.
Diabetic collapse
Those with diabetic collapse can suffer from a more severe version of flatfoot since, as a result of nerve damage, the individual often does not feel pain or discomfort from the collapse of the arch. Aside from fusion surgery and surgery that lengthens the Achilles tendon, other flatfoot reconstructive surgeries used to treat deformities in the foot as a result of diabetic collapse offered by NJ Spine and Wellness include:
- Procedures for bony prominence: Surgery can be used to remove the sizable, bony bump found on the bottom of the foot.
- Stable and unstable deformity: For stable deformity, the bony prominence is shaved away. For unstable deformity, fusion and reposition of the bones are needed.
- Fractures: When fractures occur in the softer bone of those with diabetes, they are often more challenging to repair. Fusion will require additional screws and plates for stability and bone support.
- Ankle deformity: Flatfoot as a result of diabetic collapse typically requires surgical fusion of the ankle and the joint below it to hold the foot straight.