Understanding.
Flat feet present with a reduced arch. They can be long-standing and painless, or develop gradually in adulthood with damage to the supporting tendons and ligaments.
The assessment.
The examination assesses flexibility, heel alignment, and the function of the posterior tibial muscle. Weight-bearing radiographs evaluate the deformity. Tendon imaging may be useful.
Treatments.
Flat feet without discomfort do not systematically require surgery. In cases of pain, appropriate footwear, orthotics, and rehabilitation are discussed. Reconstruction or arthrodesis may be recommended for certain persistent cases, depending on their flexibility and the associated osteoarthritis.
Follow-up.
Follow-up is based on pain, gait, and the progression of the deformity.
Surgery adapted to the flexibility of the foot
For a foot that is still flexible, correction may combine osteotomies and procedures on the tendons or ligaments. A rigid, arthritic foot may require fusion of certain joints. The treatment plan depends on the overall deformity.
After a correction
Immobilization and weight-bearing restrictions protect the bone and tendon structures. Recovery takes place over several months. Residual pain, poor bone healing, or insufficient correction are among the limitations to be discussed.
Your questions.
Do orthotics permanently correct the foot?+
They can improve support and symptoms without necessarily eliminating the deformity.
Does a long-standing flat foot require treatment?+
Not if it is well tolerated. New pain or a progressive deformity warrants an evaluation.
Is the treatment the same for children?+
No. Age, growth, and flexibility modify the reasoning. A dedicated pediatric pathway is offered starting at age 6.