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Foot & Ankle Problems Message Board

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Flat Feet Surgery
Mar 30, 2007
Hi everyone, new here to the forum. Hope you guys can give some advice on my case. Thank you.

I'm a boy who's turning 20. I've got really flat feet and tight achilles tendon. On weight bearing, its extremely flat with the navicular touching the ground and both feet are turned out (abduction). My wet foot prints show the feet pointing outwards and a protruding medial part due to the dropped navicular.

I can't stand comfortably for long. My feet, legs gety achy after a while. My posture is very poor as i'm hunching my back badly. I believe this is related to the structure of my feet. The first few steps i take in the morning after i wake up is always painful, creaky and stiff. It feels like the bones in the feet are waking up, adjusting and orientating to the position that is optimal. After the feet has "woken up", it will get better. Pain & fatigue will come again when i stand for like 10mins. I try to sit down as and when i can. At the end of a day's work, i go home, take a shower and lay down in a couch. Gradually, the feet and the knees stiffens up again. Its aching and feels really tired out to the extent that i dread getting up on my feet again. When you a working, you a focused on getting the job done and you have no time to bother the pain. Its at the end of the day when everything's finished, the pain settles in. Besides the feet, legs and knees, my lower back is painful sometimes too.

I played basketball quite frequently for the past 5 years. But i've been forced to cut down on my activity now. About 1+ year ago, i played for 3 straight hours and i can't walk the next day. Just couldn't put any weight on the feet as it would hurt the hell. I was limping for nearly a week after that. That's when it struck me that this is something serious. I still can run and play basketball now but at a lower intensity and frequency. During the exercise, i know that the pain is there but it doesn't bother me. Its after the cooling down that it begins to hurt.

i think that it boils down to the feet handling static load and dynamic load. I can run(dynamic) for quite a distance with the pain coming after the activity stopped and i've cooled off but the pain gets very bad after i'm standing(static) for a short while. I can't stand standing!

i saw an orthopaedic surgeon(specialists) after spinning around the hospital, seeing various MOs, physiotherapists and podiatrists to no avail. Physiotherapy and expensive orthotics didn't help. In fact, the orthotics were stiff that the knee pain became pronounced. The orthopaedic surgeon said other than surgery, there was nothing else he could offer. He recommended the following procedures: tendo-achilles lengthening, calcaneal osteotomy, Evans osteotomy and tightening of the spring ligament. He said that the talus bone is externally rotated. I'm able to rise up on my heels, so most likely my Posterior Tibial Tendon isn't torn. The doctor would just tighten it. There's probably an accessory navicular as seen from x-ray and it would be excised(Kidner procedure). No tendon transfer to fix the PTT sounds like good news.

my doctor would be doing a z-lengthening instead of a gastrocnemius recession as the gastro wouldn't lengthen it much. i saw 2 other doctors for their opinions. Both agreed that the lengthening is a must. Both also said that after the osteotomy corrections, the first metatarsal would not be touching the floor and it would be require correction for it to contact the ground. One recommended lapidus, which seems like an overkill to fuse the 1st metatarsal-cuneiform joint. The other doc proposed a osteotomy for the 1st ray. I think its called Cotton Osteotomy(medial cuneiform wedge osteotomy) from what i've read on the net.

i've yet to sign up for the surgery. i hope to be able to run and play basketball after the surgery, but i'm not sure if its possible. i know its going difficult and painful for post-op recovery. what are risks for this kind of operation? are the chances for a full recovery high? i've read from other posts in the forum that the younger you are, the better it is. i've read that prolonged abnormal stress due to the structural deformity in the foot will result in pre-mature arthritis.

all advice appreciated. thanks :blob_fire

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