“Flat feet,” also referred to as pes planus, is a common foot condition that affects as many as 1 in 4 people throughout their lifetime.
When you have flat feet, the arch bones in your feet are low to the ground when you’re standing upright.
Some people can live their whole lives with flat feet without thinking too much about it. For others, having flat feet can lead to foot pain and difficulty walking.
One option for treating flat feet is surgical correction. We’ll cover everything you need to know if you’re considering reconstruction surgery for flat feet.
Flat feet is a condition that often begins in childhood. During development, the tissues and ligaments in your feet typically tighten together to form an arch that supports the bones in your feet.
People with flat feet may not experience this “tightening” due to factors like genetics, poorly fitted footwear, and certain physical activities. As you age, these ligaments may loosen and cause flat feet later in life.
Conditions that can cause flat feet to develop include:
- rheumatoid arthritis
Flat foot reconstruction repairs the ligaments, tendons, and bone structure in your feet. It reshapes the foot so that your arches are better supported.
The actual surgical procedure can vary according to:
- the cause of your flat feet
- the anatomy of your ankles and feet
- the symptoms you’re looking to resolve
Pros of flat feet surgery
- provides a permanent solution to the condition of flat feet
- is considered relatively low-risk
- there’s no ongoing treatment or maintenance needed after healing is complete
- restores mobility and frees you up to do things you enjoy, improving mental and physical well-being
Cons of flat feet surgery
- long, painful recovery time (6 to 8 weeks) followed by physical therapy
- extensive time spent in a cast after surgery
- risk of blood clots and nerve damage
- possibility that the incisions or bones don’t heal correctly, worsening your symptoms
Having a diagnosis of flat feet doesn’t mean that you need surgical reconstruction.
Many people with flat feet don’t need surgery
Many people live with flat feet without experiencing pain or discomfort as a result of the condition.
Others are able to avoid surgery through nonsurgical treatment. And still other people with flat feet live with the condition because getting it repaired wouldn’t significantly change their quality of life.
No age restrictions for surgery
You don’t need to be a certain age to have flat foot surgery.
A study published in 2018 found that people over age 65 who had this type of procedure had successful outcomes as many times as people who were younger.
Candidates for surgery share these traits
You may be a good candidate for flat foot surgery if the following statements describe you:
- You have flat feet that have been diagnosed by an X-ray.
- You’re in general good health and can tolerate being put under general anesthesia.
- You have tried nonsurgical methods of treating your flat feet for a number of years.
- You experience consistent orthopedic pain.
- You’ve lost your ability to perform certain activities as a result of flat feet.
The procedure to correct flat feet will be different according to your bone structure, your ligaments, and your body type. Not everyone with flat feet will get the same type of surgery.
There are several types of surgeries that may be used to correct flat feet:
- tendon transfers: a tendon is moved from one bone to another to help with deformity
- osteotomies: bones are cut and slid into different locations
- fusions: joints are fused to eliminate pain and deformity.
You may choose to correct both feet at once, or you may correct one foot at a time.
Where the procedure is performed
Flat foot surgery is performed in a hospital. It will most likely require at least one overnight stay while you begin to recover.
During the procedure
Speaking generally, the surgical procedure will be performed under anesthesia, so you’ll be completely unconscious.
Your surgeon will make three small incisions in your foot and ankle to begin the surgery. They’ll then remove the tendon that’s linked to flat feet and replace it with a tendon that has been taken from another part of your foot.
At the same time, your surgeon will reset the bone at your heel to correct its positioning. To do this, they may insert a metal screw. They may also insert other hardware, such as a metal plate, into the top of your foot to increase the arch.
After the procedure
After the procedure, your foot will be numbed with a topical anesthetic and you may be given oral pain medications.
To keep your foot in place as healing begins, you’ll have a cast that reaches from your toes to your knees. You’ll need the assistance of a wheelchair during the initial 6 weeks as you recover, and you’ll be instructed not to put any weight on the affected foot.
The initial recovery phase takes anywhere from 6 weeks to 3 months. During that time, you’ll have follow-up appointments with your surgeon who will observe your progress every few weeks.
Once the cast is removed, you’ll probably be fitted for an orthopedic boot that’s less restrictive but still keeps your foot immobilized as it heals.
At the end of the initial healing process, you may be prescribed an ankle brace and physical therapy sessions to help your foot recover its full range of motion.
Major complications of flat foot surgery are uncommon. As with any major surgery, there are risks and side effects.
Potential complications after flat foot reconstruction surgery include:
- nerve or blood vessel damage
- failure of bones or incisions to completely heal
- blood clots or bleeding
Pain and lack of mobility as your bone and tendons heal are to be expected with this type of surgery. These side effects should begin to resolve 6 to 8 weeks after your procedure.
Your insurance plan and provider will determine whether flat foot surgery is covered. Medicare and other health plans are required to cover surgeries that your doctor deems medically necessary.
If your flat feet are negatively impacting your ability to live your life, you and your doctor may be able to make the case that the surgery should be covered.
If you don’t have insurance, or if your insurance won’t pay for this surgery, your out-of-pocket costs could be between $4,000 and $10,000.
It’s worth noting that even if your surgery is covered, you still may be responsible for hundreds of dollars in co-pays, deductibles, and prescription pain medication prescribed after the surgery.
There are other ways you can relieve pain and restore function if you have flat feet.
Unlike surgery, these treatments address the symptoms of flat feet and don’t offer a permanent solution. These alternatives include:
- prescription orthotics
- wearing a fitted boot to try to correct your arches
- physical therapy
- steroid shots to manage pain
- frequent rest and immobilization
- over-the-counter shoe inserts or orthopedic footwear
- flat feet exercises to increase mobility
Flat foot reconstruction surgery can restore mobility and functionality to your feet. Whether you inherited your flat feet or acquired the condition as an adult, these types of surgeries have a high success rate and are considered relatively low-risk.
This surgery isn’t for everyone and complications do occur. Speak with a doctor about surgery and other options to treat flat feet if your symptoms are impacting your life.