Many conservative methods have been developed for the treatment of flat feet, an unpleasant and complex disease. It happens that flat feet cannot be cured without surgery. If the doctors told the patient that it is possible to cope only with the help of surgery, try to take the decision for granted, helping the mind to quickly adjust to further treatment.
Surgical treatment of adults and children is performed without difficulty - there are no absolute restrictions in this area. There are known examples of treating flat feet in people 70 years of age and older, and operations on flat feet end successfully. The following anesthesia options are currently available:
It is possible to consult with an anesthesiologist who monitors the pain relief process and selects the desired composition of the drug. Transverse flatfoot surgery should not end in nervous shock for the patient; there are special solutions for sensitive people.
Surgical treatment of flat feet is performed in adults and children; the treatment technology does not depend on age, but is related to the degree and type of the disease. There are photographs and short videos on the Internet demonstrating the operation. With the accuracy of the smallest movement, it is possible to find out what surgeons are doing with the feet of adults or the legs of children, which will allow you not to worry about the surgical procedure.
Treatment methods for flat feet are different; even transverse flat feet, the most complex of the three types of disease, has no chance of resisting a skilled surgeon. Surgery to treat transverse flatfoot in children is performed using the latest developed techniques.
Treatment will require only low-traumatic, modest-sized incisions. If the operation is standard, the doctor will take care to secure the patient’s bones in the correct position using microscrews. There is no need to be afraid - a person will not feel the presence of devices in the feet. The screws will not disturb, preventing the foot from returning to the wrong position. In children, the need to return the foot to its ideal position is considered a priority. Special procedures called osteotomies are used for treatment. The latest techniques have made it possible to completely get rid of plaster immobilization in children and adults. The microscrews are incredibly strong, fixing the foot even more firmly than the body’s own forces.
An example of an effective operation is subtalar arthroeresis. The operation consists of using a special mini-incision up to 2 centimeters in length into the subtalar sinus of the foot, the surgeon will insert a special titanium implant. The material is incredibly strong and durable. After correct installation of the implant, the patient will not feel any discomfort; the foot will return to the position intended by nature. Implants are necessary to correct the longitudinal arches of the foot; flat feet will completely disappear from the patient. Previously, such an operation was unimaginable, but now the procedure has become a reality that is easy to use. The operation lasts 30 minutes, you will need to stay in the clinic for a day.
The procedure has many advantages, including the possibility of surgery for children and adults. The full procedure lasts half an hour. No cast or crutches are required. The surgeons who performed the operation will develop special orthopedic insoles that fix the result.
For high-quality treatment results, you only need to seek help from professionals in a timely manner.
Surgical intervention involves correcting finger deformities without cutting the skin. The surgeon will perform small, practically invisible punctures, which are performed using the finest burs of various shapes. After the mentioned method, daily dressings are not required. European medical centers have long been using the technique, which continues to gain popularity around the world.
When operating on adults and children, a long and complex recovery process is not required. If we talk about restoring the position of the foot with the help of microscrews, the following are performed during the day:
In the case of correcting the situation by removing the “bones,” even dressings are not required. Surgeries that restore the foot using implants have become widespread. The procedure lasts 10-15 minutes. It cannot be called consistently effective; the intervention is ideal for young patients - exclusively up to 25 years of age, when it is possible to effectively compensate for the deformity.
The operation is also used after 25 years, as a stage of treatment, for primary reconstruction of the foot. As part of this operation, the heel tendon is lengthened and the forefoot is reconstructed. Modern implants continue to improve; they are reliable and easily fix the foot in the desired position. Transverse flatfoot is not a disease that can be quickly cured with implants. If the patient has transverse flatfoot, treatment with implants will only be part of the procedure.
Surgical correction of flat feet is possible; the disease should not be ignored. The incision through which the surgeon will operate on the bones will be small. There is no risk of pain during wound healing; it is possible to use self-absorbing threads for suturing - the technology is well thought out and comfortable for the client.
Transverse flatfoot is a change in the shape of the foot, characterized by drooping of its transverse arch. With this pathology, a decrease in plantar length occurs due to the fan-shaped divergence of the metatarsal bones and the displacement of the first toe outward.
Flat feet can be transverse, longitudinal and combined (combined). Most often (more than 50% of cases) transverse flatfoot occurs, sometimes in combination with other foot distortions (for example, hallux valgus or varus deformity). The orthopedic problem is mainly detected in adults, however, sometimes children and adolescents are affected by the disease.
Weakening of muscles and ligaments leads to disruption of the uniform distribution of body weight on the plantar area, so the bones and phalanges of the lower extremities have to take on additional load. This provokes the “spreading” of the foot and over time it acquires a flattened shape.
Reasons for the development of transverse flatfoot:
As the pathological condition progresses, increasing discomfort is felt, which then transforms into pain and burning. At the beginning of the development of flat feet, a person often does not attach importance to such alarming signals as heaviness in the foot after prolonged standing, walking or physical activity. Pain usually occurs at the junction of the first and second fingers.
Progressive flat feet also entails other symptoms:
The most characteristic symptom of transverse flatfoot is the development of valgus deformity of the first toe, referred to in medicine as bursitis. This pathological condition develops due to constant mechanical irritation.
The process of development of valgus deformity in transverse flatfoot
First, the doctor examines the foot visually. Smoothing of the indentation on the sole, changes in the location of the toes, swelling and soreness of the leg are taken into account. A survey is also conducted regarding hereditary factors, the presence of cardiovascular or rheumatic diseases.
Instrumental diagnostic methods:
The development of transverse flatfoot involves nearby vessels and nerve fibers in the pathological process. Considering this fact, the patient is recommended to have additional consultation with a phlebologist and neurologist.
Doctors note that the disease has become noticeably younger: if previously it mainly affected older people, now more and more people aged 25-55 years are turning to the doctor with complaints about a growing “bone”, as well as pain in the foot, fatigue and swelling of the legs.
For each patient, treatment is selected individually. Therapeutic intensity depends on the degree and severity of the pathological process, the presence of pain, inflammation and swelling, damage to nearby vessels, joints, tendons, nerve and muscle tissues.
Walking barefoot can be beneficial, especially on soft soil such as beach sand. This provides a good muscle workout, helping to stop and treat the development of transverse flat feet. This procedure will be harmful only in the last stage of the problem or in the presence of certain concomitant diseases such as plantar fasciitis (pain and inflammation of the tissues connecting the palpations and the heel bone).
At home, treatment for flat feet can also be carried out by performing a set of exercises to develop muscles, the weakening of which leads to the development of this disease.
A good exercise to treat flat feet
bend your knees and spread them slightly without lifting your heels from the floor. When looking down, your kneecaps should be further than your third (middle) toe.
More complex and lengthy gymnastics for the treatment of transverse flatfoot are shown in the video.
Correction with the help of special medical devices is effective in the early stages of the disease. For inflammation of the metatarsophalangeal joint, bolsters are prescribed, which are placed between the first and second toes and attached to the lateral surface of the foot. This allows you to return the first finger to its anatomically correct position.
To restore the physiological bend of the foot, special insoles are prescribed that reduce the load on the ankle joint and spine and prevent the progression of the disease.
To support the foot after surgery or in severe cases of pathology, orthopedic shoes are prescribed.
Therapeutic measures are recommended to relieve inflammation and pain in muscles and joints. The medication group that has the best effect is non-steroidal anti-inflammatory drugs (NSAIDs) based on Indomethacin, Ketorolac, Diclofenac. Typically, the dosage form prescribed by a specialist is an ointment, gel, tablets or dragees. For unbearable pain and severe inflammation, intramuscular or intravenous injections are prescribed.
This type of treatment is considered auxiliary and is usually used for 1-2 degrees of transverse flatfoot, as well as for rapid recovery (rehabilitation) after surgery. For inflammation, physiotherapy is prescribed (mud baths, UHF, electrophoresis). The goal of physical therapy is to strengthen the muscles and ligaments to naturally support the foot and prevent the progression of pathology.
Today, surgery is considered the most effective method of restoring the anatomy of the foot. Using this method, you can eliminate the orthopedic disease and return the thumb to its natural position.
During the operation, the tendons and muscle tractions responsible for the position of the first and second toe are redistributed. This is achieved by resection of the main tendons and moving them into the desired position. Sometimes, before carrying out the above actions, partial removal of the bone fragment is performed.
Many patients want to get rid of the “bone”. This is a cosmetic operation during which only the bony growth and the subcutaneous bursa forming the enlarged joint are resected.
In addition to the benefits of walking barefoot on sand or other crumbly soil mentioned above, it is worth noting the role of properly selected shoes for the formation of a normal arch of the foot and the prevention of transverse flat feet.
One medical study conducted in India on a large number of children found a lower prevalence of flat feet in those who wore sandals and slippers compared to the group wearing closed shoes. It turned out that closed toes greatly inhibited the development of the arch of the foot compared to slippers or sandals.
Scientists have also found that wearing shoes throughout early childhood can be harmful to the arch of the foot. At the same time, the chances of developing transverse flatfoot increase when a child walks in stretched, worn-out shoes or ones that are larger than the size he needs.
Please note that the above recommendations are not a call for self-medication! Timely diagnosis, the correct choice of method for eliminating the disease and fulfillment of all rehabilitation conditions will allow you to eliminate flat feet as quickly as possible and solve cosmetic problems associated with it.
Flat feet is a term used to describe very little or no arch in the foot. In this case, the foot ceases to absorb the load and this role is taken over by the ankle, knee and hip joints, and additional load is placed on the spine. Because of this, the joints wear out faster.
There are different stages of flat feet. It happens that a person lives with this disease for years, and it does not cause any discomfort. However, when flat feet cause foot pain, it can lead to significant daily discomfort and limited activity.
There are flexible (elastic) and rigid types of flat feet. With flexible flat feet, an arch appears when the body weight is not transferred to the foot. In contrast, a stiff, flat leg is “stuck” in a flat position whether there is pressure on the leg or not.
The degree of flat feet does not always correlate with the degree of symptoms. Patients may complain of foot pain and heel pain. Muscle cramps in the lower leg may occur. Many patients feel pain during physical activity, such as walking or running. Irritation from shoes can cause redness and swelling of the feet.
Flatfoot surgery (foot reconstruction) is performed to relieve pain and restore foot function in adults and children whose arches are virtually absent and conservative treatment methods have failed. Arch problems can be caused by a deformity, damage to the tendon that supports the arch, or arthritis in the joints around the heel.
There are two main arches in the human foot - longitudinal and transverse. With a longitudinal deformation of the foot, it becomes longer; with a transverse deformation, it becomes wider, as the distance between the bones of the metatarsus increases, but at the same time it becomes shorter. There is also a combined longitudinal-transverse flatfoot, when the surface of both the transverse and longitudinal arches of the foot is in contact with the surface.
Flatfoot surgery is recommended only for high degrees of longitudinal flatfoot (degree 2-3). With the first degree of longitudinal flatfoot, it is enough for the patient to wear orthopedic insoles.
In case of transverse flattening of the foot, flatfoot surgery is recommended to correct the deviation of the first toe inwards (a pathology known as hallux valgus), the formation of bone growths and lumps on the big toe that interfere with walking, with prolonged bursitis and displacement of the metatarsal bones.
The goal of surgical correction of flat feet is to straighten the foot. This contributes to normal shock absorption when walking and pressure when standing.
Surgery for the treatment of flat feet is divided into three types: on soft tissues (ligaments and tendons), on bones (osteotomy or intersection of one or more metatarsals) and union of bones so that they grow together in a normal position.
Depending on the severity of flat feet, the structural features of the foot and the age of the person, the type of operation depends. In most cases, a combination of procedures is performed.
For flexible flat feet, surgery is aimed at maintaining the movement of the foot and recreating the arch. Typically, surgery involves restoring the function of the tendons along the inside of the foot. This helps strengthen the underlying tendon that lifts the arch.
When the bone deformity is too severe, the surgeon physically realigns the arch.
For rigid flat feet, surgery focuses on restoring the shape of the foot.
The most common surgeries for flat feet include:
The cost of surgery for flat feet depends on the severity of the disease and ranges from 60 to 100 thousand rubles, not counting the price of microscrews and implants.
Immediately after flatfoot surgery, the operated leg will be in a cast up to the knee and will feel numb and painful.
The patient will be prescribed painkillers. During the first few weeks, you should elevate your leg above the level of your heart while lying down to reduce swelling.
Move only when absolutely necessary, such as going to the toilet or showering. You should not put any weight on your operated leg. Also, do not get the plaster wet.
Smoking and taking anti-inflammatory drugs should be avoided as these may delay or even prevent bone healing.
Primary healing takes about two weeks.
After this period of time, the doctor will check the wound, perform a physical examination and x-rays, and make a new plaster cast. During this time you will have to walk on crutches.
After six weeks, a new x-ray will be ordered and the cast will be removed. The patient will be given an insole or bandage (support) to wear with their shoes. You will also have to use crutches during this time.
In three months you will need to appear for the next medical examination. It will be possible to walk without crutches, but with orthopedic insoles and comfortable shoes (not heels).
In six months, the leg will be completely healed. At this time, there will be no need to use orthopedic insoles.
If the wound becomes red, swollen, or painful during the postoperative period, you should contact your doctor to rule out an infection.
You can return to work three weeks after flatfoot surgery. But if it involves physical activity, up to 12 weeks of rehabilitation may be required.
Most people are able to return to normal life and exercise six months after surgery. A podiatrist may recommend wearing orthotics to help maintain a healthy arch, especially during sporting activities.
There are not many complications after flatfoot surgery, but they should not be completely excluded.
Here's what may happen after surgery:
A foot deformity that is not an independent disease of the musculoskeletal system is called flat feet. It develops as a complication of the following health conditions and disorders.
A foot deformity that is not an independent disease of the musculoskeletal system is called flat feet. It develops as a complication in the following health conditions and disorders:
One type of foot deformity, which is considered a complication of the disease, is planovalgus feet. In this condition, the feet “fall” inward - this is best seen when viewed from behind: when walking, the heel assumes a position inclined to the ground. Patients with planovalgus feet also experience severe and uneven shoe wear: the heel wears away only on the inside.
Without treatment, flat feet are fraught with serious complications, which over time significantly worsen the patient’s quality of life and reduce his motor activity. Violations of the spring functions of the foot - loss of the ability to absorb shock when walking, jumping and running - leads to problems with general health. Pain in muscles and joints, difficulty walking are only the first symptoms that flat feet adversely affects the entire body. As the deformation of the arch of the foot increases, compensatory changes begin in the spine: the bends of kyphosis and lordosis increase, compensating for the uneven distribution of the load on the back.
Today there are several treatment methods:
The first three treatment methods are usually prescribed in a comprehensive manner. In this case, the causes of flat feet are of great importance: surgery may be indicated as the main treatment for foot deformity if flat feet have developed due to injury or improperly healed fractures of the bones of the foot.
Flat feet are difficult to treat with conservative methods. To restore the physiological structure and function of the foot, it is often necessary to resort to surgery. In recent years, minimally invasive techniques have been widely used, which are characterized by low trauma and can significantly reduce the postoperative period.
Surgery for flat feet is not performed at every stage of the disease. For the first degree of foot deformity, conservative treatment is possible. Even with the second degree of the disease, with some effort it is possible to achieve a positive result without resorting to surgical correction. However, it is done if a person cannot fulfill the recommended requirements. In the third and fourth stages, surgery for flat feet in adults is the only effective treatment.
Surgery is a radical method of treatment; it is performed if all other methods have no effect.
There are no strict contraindications for surgical treatment of the disease. There are situations in which surgical treatment of flat feet may be delayed. This is the presence of an acute infectious disease in humans, dermatological diseases of the foot. Once these obstacles are removed, surgery can be performed.
The tactics of surgical treatment of flat feet largely depend on the type of pathology. For longitudinal and transverse flatfoot, several types of operations are used. It is performed under general anesthesia or general anesthesia.
Until recently, for longitudinal flatfoot, extra-articular arthrodesis of the talus in combination with tendon grafting was used. The essence of the operation was that the ankle joint was cut in the area of the talus, and then the tendons of the foot were sutured. As a result, the bones took the correct position. The operation to correct flat feet was quite traumatic and painful.
A minimally invasive technique is often used. During the operation, a small incision is made in the foot and a titanium plate is placed in the subtalar sinus. It opens up the flattened bones, thereby restoring the deformed sinuses of the foot. The operation itself lasts no more than half an hour, and the recovery period takes a day.
It is recommended to use this method of treatment for flat feet in children and adolescents. Walking is allowed immediately after the intervention; the sutures are removed in the second week. Full load on the feet and sports are allowed after three months. All this time, a person must wear special shoes with orthopedic insoles.
In case of severe deformation of the foot, in addition to placing the implant, the tendons on both sides of the foot are sutured. After this, the leg is cast and the person must walk on crutches. Therefore, the feet are operated on one at a time.
This operation is not recommended for people over 30 years of age, since their bones are fully formed and pain may develop.
For transverse pathology, two surgical tactics are used:
The first method is used for moderate flat feet. The second method is indicated for deformation of the fingers, the formation of a protruding “bone” in the area of the thumb.
Stretched tendons are strengthened with special wire. An incision is made in the area of the metatarsophalangeal joint. The surgery lasts about half an hour, and the person is immediately allowed to walk. However, this type of elimination of pathology does not guarantee a complete cure for flat feet; after some time, the ligaments may weaken again.
A more effective operation for flat feet is arthroplasty. During the intervention, bone growths are removed and articular angles are restored. First, the metatarsal bones are sawed, then the correct arch of the foot is formed, and then fixed with screws. When a lump forms on the thumb, an osteotomy is performed - dissection of the phalanx of the finger and removal of the growth.
After any operation, it is recommended to follow some rules:
You must come for a weekly check-up with a doctor.
After operations to eliminate flat feet, complications rarely develop. Among them may be:
To prevent this from happening, the patient should carefully follow the doctor’s recommendations in the postoperative period.
Patients leave positive reviews about flatfoot surgery.
I have had flat feet for 10 years. In recent years, I have been experiencing severe pain in my legs and my gait has become impaired. I constantly do massage and gymnastics, wear special shoes. Apparently these methods don't help. The doctor suggested surgical treatment for flat feet. The price is high, but health is more expensive. The operation was done quickly, and she was in the hospital for a little over a week. Three weeks later the stitches were removed. The pain when walking has practically stopped. It’s true that walking is a little uncomfortable, as the shape of the foot has changed. But the doctor said that over time I will get used to it. I am satisfied with the operation, everything went quickly and painlessly.
Irina, 42 years old, Tver.
I have suffered from transverse flat feet for a long time. Over the past year, a large lump has formed in the area of the thumb. It is painful and makes it difficult to walk. Doctors say that the only treatment is surgery. I agreed to do it. They operated quickly and removed the resulting bone. They told me to bandage my leg for two weeks, then wear orthopedic insoles for three months. Walking became much easier, but the doctor warned that relapses were possible.
Yulia, 36 years old, Saratov.
For severe flat feet, the only effective treatment is surgery. There are several types of surgical interventions, for which there are indications. Their effectiveness is quite high, the postoperative period usually proceeds without complications.
Hallux valgus is an orthopedic disease that manifests itself in a pathological change in the shape of the toes, in which they occupy a position at an angle to each other. The most common form of the disease is hallux valgus, which can be easily identified by its external sign - a tubercle protruding to the side in the area of the toe base.
The pathology not only brings discomfort while walking and spoils the aesthetics of appearance, but also leads to the development of arthritis, bursitis, circulatory disorders, and injuries in the ankle area. The causes of hallux valgus (Hallux valgus) are:
There is numerous evidence of the fact that ballerinas, as well as women who prefer to wear high-heeled shoes, are significantly susceptible to the disease. An imbalance of the ligamentous-tendon complex, which develops with excessively high elasticity of the joints, leads to transverse flatfoot, and as a consequence, to Hallux valgus.
The slow progression of the disease does not always allow diagnosis at an early stage, when the deformity can be corrected through the use of conservative therapy and orthopedic devices (orthoses). A soft formation that appears at the base of the first finger is often mistaken for a callus, and traditional methods are used to get rid of the defect. Naturally, such treatment does not produce results - over time, the tubercle hardens, increases in size, and causes pain when walking.
In the next stage, the first toe becomes noticeably curved, deviating toward the outer edge of the foot and displacing the remaining toes. The metatarsophalangeal joint is subjected to excessive loads, which leads to inflammatory and degenerative processes in the bone tissue (Hallux rigidus). When the big toe is deviated by an angle of more than 30 degrees, deformation of all toes occurs (hammer toe, corns, ingrown toenails).
In orthopedics, there are three degrees of Hallux valgus:
The degree of deformation of the osteoarticular complex is the main factor when choosing surgery for hallux valgus.
The main indication for surgery is pain and discomfort when walking, the development of inflammatory and destructive changes in bone tissue. Hallux valgus deformity of the foot (Halus Valgus) can be treated conservatively only in childhood and early adolescence, before the formation of the skeleton is complete.
In an adult, you can only stop the progression of the pathology, partially relieve pain, restore the physiological load on different parts of the foot, and also prevent the development of serious complications. For this purpose, orthopedic devices (insoles, inserts, clamps, bandages) are used. The problem with Hallux Valgus can only be completely solved by surgical methods.
The surgical plan is developed individually for each patient, since this type of pathology is characterized by a wide variety of manifestations and complicating factors, the most common of which are: bursitis of the small toes, arthrosis of the metatarsophalangeal joint, osteomyelitis, arthritis, soft tissue infections.
The choice of surgical technique is determined by the nature of the pathology, the severity of tissue damage, and the presence (absence) of relative contraindications. At the first stage, a gentle technique (mini-invasive) is used, in which soft tissues and tendons are minimally affected.
The purpose of the operation is to restore the aesthetics of the appearance of the foot and eliminate discomfort when walking. This type of surgery allows you to quickly restore your physical shape and endure the rehabilitation period painlessly. At the same time, the possibility of developing a secondary process of hallux valgus in the distant future cannot be ruled out. For grade 3 hallux valgus deformity, minimally invasive techniques are not used.
The first stage is the excision of the bone growth and subcutaneous mucous bursa adjacent to the base of the first metatarsophalangeal joint. The operation is performed under X-ray control (EOC), without open access to the surgical field. To carry out the manipulations, two small punctures are made on both sides of the first finger (3-4 mm).
Using micro-instruments, the joint capsule is opened, a lateral release is carried out (the correct position of the axis of the first finger is restored), part of the bones are filed using micro-mills - to completely eliminate the deformity of the thumb. Minimally invasive surgery does not involve the use of fixations (pins, screws, plates or staples).
The reconstructive surgery technique includes the following steps:
The metatarsal bone is sawed using one of the following methods:
The operation to remove the bunion of the thumb (halux valgus) is as follows:
An important point is that when performing a chevron osteotomy, the surgeon constantly monitors the position of the sesamoid bones using an image intensifier X-ray, given that the area of their displacement is limited.
The type of anesthesia (local anesthesia or general anesthesia) is selected individually, according to medical indications, and with mandatory agreement with the patient.
Absolute contraindications to surgery are:
Arthritis and arthrosis are not contraindications to surgical treatment, but when choosing a surgical technique, possible complications during the surgery itself and during the rehabilitation period are taken into account.
After reconstructive surgery, the same complications that are observed with any abdominal surgery may develop:
The listed complications occur rarely; in general, patients tolerate the operation well, both young and old.
On the first day after surgery, bed rest is indicated. Light development of the foot can be done - the patient moves his toes several times a day. Walking is allowed on the third day, and only in a special orthosis, which removes the load from the operated part of the foot.
Restoration of normal walking mode (without using an orthosis) - no earlier than after 6 weeks. Complete rehabilitation is achieved within 4-6 months (after this period, you can actively engage in sports and wear high-heeled shoes). The length of stay in the clinic under the supervision of a doctor is from 10 days to two weeks. The patient should be aware that swelling in the foot and lower ankle after surgery can persist for quite a long time, up to three months. To reduce swelling, log compresses are used during moments of rest.
To speed up the rehabilitation process, the leg (in a lying position) is kept at a height. If the recommended loads are exceeded, a burning sensation and pain in the foot area may occur, which is sometimes caused by displacement of the fixator. You should take medical indications after surgery responsibly - the speed of recovery depends on the punctuality of compliance with rehabilitation requirements.
To increase the efficiency of tissue healing and restore the functionality of the foot, shock wave therapy sessions, massage (at least 15 procedures) of the leg (from foot to thigh), electrophoresis, and physical therapy are used. Two months after surgery, the recovery program includes swimming and exercise on an exercise bike.
Judging by patient reviews, surgery to correct a deformed thumb allows you to return to your normal lifestyle, wearing high-heeled shoes, without experiencing pain or skin irritation. The aesthetic appearance of the foot is completely restored; relapses do not develop when titanium fixators are used.
The cost of the operation depends on the status of the medical institution where treatment is performed, the degree of destructive changes in the osteoarticular complex, the presence (absence) of complicating factors, and the type of surgical technique chosen. The average price of surgery is 35 thousand rubles, but this amount does not include the cost of the rehabilitation period. “Surgery plus recovery” is the average amount of the order.
CUSTOM ORTHOPEDIC INSOLES
More than ten years ago, a technique was developed for the treatment of flat feet , which is based on the production of individual insoles from special flat semi-finished insoles. The advantage of this development is that the insoles are made taking into account the individual characteristics of each of the patient’s feet.
The basis of such an individual insole-support is heat-labile plastic. The insole takes on a plastic shape under the influence of temperature, is modeled directly taking into account the anatomy of the foot, hardens and fully corresponds to the individual characteristics of the human foot
The process of making custom insoles is quite simple, although it does require skill and a basic understanding of the anatomy of the foot. Frankly, I had to remake incorrectly (poorly) insoles made according to the same principle many times in other clinics.
Initially, the patient’s feet are examined using a plantoscope to identify one or another type of flatfoot in the patient. The size of the feet is determined using the Haider measurement.
Next, a rubber band is placed under the foot across the longitudinal arches; if there is transverse flatfoot, a metatarsal drop is added, which is installed directly under the heads of the metatarsal bones.
The semi-finished insole is heated with a special hairdryer, when the plastic base of the insole becomes soft (plastic) under the influence of temperature, the insole is placed under the foot.
How is arch support modeling done? It’s very simple: by pulling a rubber band, the longitudinal arches of the foot are raised to a physiological height, and the imprint of the metatarsal drop forms the transverse arch of the foot. The manipulation takes 1 minute. The insole is modeled identically for the opposite foot.
All you have to do is wait 5 minutes, the insoles will cool down, you can try them on in your shoes, and wear them to your health!
As a rule, insoles are in most cases used in shoes without heels, but if an insole is needed for shoes with heels, then in this case the insoles are modeled on special blocks of different sizes in accordance with the height of the heel.
After making insoles, some patients experience some fatigue in their legs at first, but this is a completely normal situation, your feet just need to get used to it.
Individual insoles are also made for children, preferably from 2-3 years old. The peculiarity is that children need gradual correction (taking into account the growth of the leg). Treatment of flat feet in children will relieve the child of this problem and allow him to form healthy feet.
SURGICAL TREATMENT OF FLAT FOOT
Currently, surgical methods are used to treat flat feet.
Taking into account the fact that recently a lot of patients want to correct flat feet surgically, I want to clarify this issue completely. It is worth noting that not all types of flat feet can be corrected with surgery!
Surgical treatment is sought if it is impossible to correct flat feet with insoles. Such operations are carried out only in cases of pronounced longitudinal flatfoot of high degrees (grade 2-3). For grade 1 longitudinal flatfoot, it is best to wear insoles rather than think about surgery. If the patient has transverse flatfoot, then to unload the transverse arch of the foot, either insoles or other methods of surgical treatment are used (see section Bones on the feet).
Currently, an innovative method of surgical correction of flat feet—subtalar arthroeresis—is used to correct flatvalgus feet. The essence of the operation is that a special titanium implant is placed from a mini-incision (1.5-2 cm) into the subtalar sinus of the foot. Installation of this implant allows you to change the pathological position of the bones of the foot, thereby correcting the longitudinal arches of the foot and eliminating flat feet.
In our practice we use various titanium implants: VILEX (Germany) or KALIX (France).
The operation takes about 30 minutes. The hospital stay at the clinic is only 1 day.
As a rule, such operations are most effective in adolescence and young adulthood. The optimal age is from 10 to 20 years. At this age, the feet are still growing, they are not yet “ripe”, so surgical correction will be very effective and non-traumatic.
Children and adolescents can undergo surgery on both feet at once.
No cast or crutches required. You can walk immediately after surgery.
After the operation, we make sure to make individual orthopedic insoles for the so-called external support of the operated feet.
The sutures are removed 2 weeks after surgery.
Sports activities are allowed at least 3 months after surgery.
But with severe flatfoot deformity (in a teenager or adult), installing an implant to correct flatfoot is not enough. Along with subtalar arthroeresis (implant installation), it is necessary to perform plastic surgery of the posterior tibial tendon and subcutaneous marginal tenotomy of the Achilles tendon.
Such combined operations are performed only on one foot, since after the operation you cannot step on the foot (crutches are used) + the leg is fixed with a synthetic plaster splint for 6 weeks. Surgery on the opposite foot is usually performed after 1 year.
The subtalar implant requires removal. In children, the implant can be removed upon completion of growth (at the age of 17-18 years); in adults, the implant is removed on average 1.5 years after installation.
Paradoxically, while the implant is in place, the foot remembers the given correction, and after removal it retains its shape.
In older people (over 30 years old), the installation of subtalar implants is not recommended, as it is fraught with constant pain. In this case, other types of surgical treatment are used to correct the flatvalgus foot: arthrodesis of the talonavicular joint or varius osteotomy of the calcaneus.