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THE UK'S FIRST AND MOST EXPERIENCED DEDICATED COSMETIC FOOT SURGERY CENTRE

Flat Foot

What is a flatfoot?

Many patients have a low arch when standing, but this doesn't necessarily mean that treatment is required. However, many patients will develop pain in association with a flatfoot where the mid and rearfoot (hindfoot) joints become collapsed and misaligned and the soft-tissues such as ligaments and tendons become over-stretched and inflamed. There are several causes with names such as collapsing pes valgo planus (CPVP), tibialis posterior dysfunction and hyper or over-pronation. Rarely, children can be born with hindfoot bones misaligned (e.g. vertical talus) and bones that are joined together, which should be separate (tarsal coalitions). These tend to cause a very inflexible or rigid flatfoot.

The majority of presenting flatfoot conditions seen in our clinics are "adult acquired”, with a non-rigid or flexible deformity.

Symptoms

May present in a variety of ways, randging from arch pain, swelling and pain under the ankle bone with joint pain in the arch. Poor function and early fatigue when walking, particularly in children are also frequent symptoms due to the inefficiency of the locomotor system. In this condition the flattening or over-pronation causes the leg muscles to over-work when walking or exercising. Pain can also be higher up above the foot, for example in the knee joint, hip joint or lower back due to the general poor posture which over-rotates the leg inwards. Tightness of the Achilles tendon and calf-muscle can also lead to collapse of the arch and genu valgum (knock-knees) genu varum (bow-legs) can all cause the foot to collapse down.

What types of surgery are available?

Flatfoot surgery has changed enormously over the last 30-years. More complex surgeries such as heel bone surgery (osteotomies) and joint fusions, still have their place and are widely practiced around the world, but these are high-risk invasive surgeries, with long recoveries and prominent scarring.

The Hyprocure (HyProCure) Stent – keyhole surgery

The Hyprocure procedure is a minimally invasive surgery, with a total surgery time of approximately 15-20 minutes, through a small incision below the outside ankle bone. Patients can be back to normal walking within a few weeks.

The small titanium stent is inserted into the sinus tarsi, correcting the flat foot at its root by keeping the sinus tarsi (between the talus and calcaneus in the hindfoot) in a stable open position. This stops your ankle bone from sliding forward over your heel bone, which causes the foot to collapse down. The procedure also helps the rest of your body in its natural alignment.

After Surgery

You will have some degree of pain and swelling and the swelling usually persists for several months. We find patients benefit from wearing a protective walker boot for a month or so afterwards. Return to work may be as little as 2-weeks depending on how much weight-bearing/walking you do at work.

Some patients report the feeling of having a sprained ankle, which is normal and should settle with time. Patients don’t usually need an in-shoe orthotic afterwards, but if you feel like you need the support, we can provide this.

Some patients don’t tolerate the implant and the procedure can be reversed by removing the implant. Sometimes there is excessive inflammation around the implant and a cortisone injection may be required to settle this down.

In some cases, additional procedure may be required such as Achilles tendon lengthening and / or repair of damaged tendons and ligaments along the inside arch of the foot. If this is suspected at assessment, additional scans apart from the normal x-rays required; such as ultrasound or MRI scans, may be necessary.

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Call us: +44 (0)207 870 1076  Email us: jackie@foot-surgery.co.uk