Flat foot surgery aims to restore the arch at the base of the foot. Surgery may involve cutting bones, replacing tendons, or strengthening ligaments.

An individual with flat feet has either no arch on the bottom of the foot or unusually low arches. Around 5–14% of people have flat feet, also known as “pes planus.” Treatment options range from pain medications to specialized footwear.

This article examines the purpose of flat foot reconstruction surgery and who it might benefit. It also describes how to prepare for surgery, recovery, and a person’s typical outlook following surgery.

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Reconstruction surgery for flat feet is any surgical procedure that aims to restore some arch underneath the foot.

As a 2022 review explains, flat feet result from the loss of the medial longitudinal arch. This part of the foot is tough and elastic. It contains an interconnected array of tendons, ligaments, and collagen. Flat feet can result from issues in any part of this structure.

For this reason, flat foot surgery can vary. According to a 2019 meta-analysis, the following reconstruction surgeries are common for flat feet:

  • medial displacement calcaneal osteotomy
  • lateral column lengthening
  • modified triple arthrodesis
  • flexor digitorum longus transfer
  • indicated triple arthrodesis
  • double arthrodesis

Any of these could restore some of the medial longitudinal arch. A doctor can recommend the surgery they expect to work best for an individual.

Learn more about flat feet.

Some people are born with flat feet. However, most cases of flat feet do not require treatment, and the condition typically resolves on its own.

Doctors may recommend surgery for children with flat feet in some cases. This may happen if a child has rigid flat feet, where they have no medial longitudinal arch, regardless of whether they place any weight on their feet.

Some people develop flat feet during adulthood. For these individuals, foot orthotics, nonsteroidal anti-inflammatory drugs, and motion-control shoes can be helpful. Doctors only recommend surgery if other treatments are ineffective.

A doctor will explain how to prepare for surgery.

A study in the journal Preoperative Medicine explains that it is best for an individual to speak to various healthcare professionals several weeks in advance of a surgical procedure. These include:

However, the same study notes that most people who have surgery do not receive this optimal preoperative care.

The United Kingdom’s National Health Service (NHS) offers the following advice for preparing for surgery:

These steps may improve a person’s ability to recover from flat foot surgery.

People will need to arrange transport home from the hospital, as they will be unable to drive.

Firstly, an anaesthesiologist administers general or local anesthetic. General anesthetics are more common for this procedure, although some people receive local or spinal anesthetic, which numbs only the legs.

During the procedure, surgeons make incisions inside the foot. They may use saws to cut bones and metal plates or screws to hold bones together. They might remove damaged tendons before replacing them with healthy ones. Surgeons could also repair damaged ligaments with special tape.

After the operation, surgeons stitch together any remaining incisions. The person having surgery should receive some local anesthetic to ease post-operative pain. Healthcare professionals then put the person’s foot in a cast.

In most cases, an individual can go home the day after surgery.

During the first 6 weeks after surgery, the individual will need to avoid placing any weight on the leg and keep it elevated for as long as possible.

After 6 weeks, the individual will likely have an X-ray to check how well the foot is healing. At this point, doctors may recommend a surgical boot or removable cast if it is healing well. The individual can then slowly and carefully begin to place some weight on the leg.

After another 6 weeks, the individual will receive another X-ray. If the doctor is happy with how the healing is progressing, they may recommend a special supportive shoe. They may then refer the person to a physical therapist to teach the individual how to use and strengthen their reconstructed foot.

Learn more about how physical therapy can help.

Surgery can slow down flat foot progression and reduce symptoms such as:

Some surgical interventions may be better than others.

In particular, evidence suggests that medial displacement calcaneal osteotomy, lateral column lengthening, indicated triple arthrodesis, and double arthrodesis may be the most effective flat foot reconstruction surgeries.

However, doctors cannot guarantee that the surgery will help with flat feet.

As with any surgery, having a procedure for flat feet carries risks, such as:

People will need to carefully consider the possible risks and benefits of flat foot surgery before deciding if it is right for them.

Having flat feet does not always require treatment. The condition may resolve itself or be asymptomatic for long periods. However, flat feet can sometimes cause pain and difficulty walking. It may also predispose people to injury.

Flat foot reconstruction surgery aims to restore curvature to the medial longitudinal arch of the foot. This can help with flat feet symptoms and prevent further flattening. However, surgery carries risks.

Doctors have many ways of reconstructing the medial longitudinal arch. However, there is evidence that medial displacement calcaneal osteotomy, lateral column lengthening, indicated triple arthrodesis, and double arthrodesis may be especially effective types of flat foot surgery.