Flat foot reconstruction is a complex operation for adult-acquired flat foot deformity that has not responded to orthotics and physiotherapy. The exact procedure depends on the stage of the deformity, but typically combines bony realignment with tendon transfer.
ℹ️ This appointment takes place 2-4 weeks before surgery. Flat foot reconstruction is a major procedure, so the assessment is thorough.
You will meet the nursing and anaesthetic teams. A full medical review is carried out, with particular attention to diabetes control and circulation if relevant. The team will discuss the specific procedure planned for your foot.
Full pre-operative screen.
Blood thinners, anti-inflammatory drugs, and diabetic medication may need to be adjusted.
Usually performed under general or spinal anaesthesia, with a popliteal nerve block for post-operative pain relief lasting 12-24 hours.
The exact combination of procedures (calcaneal osteotomy, lateral column lengthening, tendon transfer, joint fusion) is confirmed with the surgeon.
You will be non-weight-bearing for 6 weeks. Arrange a downstairs sleeping area if possible and ensure help is available for at least the first 1-2 weeks.
ℹ️ You will be given a specific arrival time. Do not eat or drink (other than clear water up to 2 hours before) from midnight the night before. Bring your medication list and any documents sent by the hospital.
You will be admitted to the ward or day surgery unit, change into a gown, and be seen by the nursing, anaesthetic, and surgical teams before theatre.
Your surgeon will confirm the procedure, mark the operative side, and you will sign a consent form before going to theatre.
You will meet the anaesthetist in the anaesthetic room. Once anaesthesia is established, the procedure will begin.
After surgery you will wake in the recovery room where nurses monitor your vital signs until you are stable and comfortable.
Most foot and ankle surgery is performed as a day case, meaning you go home the same day. More complex procedures such as ankle replacement or flat foot reconstruction usually require 1-3 nights in hospital. Before discharge, the team will check your pain is controlled, give you wound care instructions, and confirm your follow-up appointment.
You will be given oral pain relief before discharge. Take it regularly for the first 48 hours rather than waiting until pain is severe.
A nurse will check the wound before you leave and explain how to keep it clean and dry.
You will be shown how to use crutches and given clear instructions about weight-bearing on your operated foot.
You will receive a letter for your GP and details of your next outpatient appointment, usually at 2 weeks for a wound check.
Arrange for a family member or friend to collect you. You must not drive after a general anaesthetic or sedation.
⚠️ Important: This is a complex operation with a long recovery. Wound healing problems and stiffness in neighbouring joints are recognised risks. Do not weight-bear against advice, early loading can compromise the realignment.
Keep the foot elevated above the level of your heart for as much of the day as possible during the first 2 weeks. This significantly reduces swelling and helps healing.
Avoid getting the wound wet until it is fully healed, usually 10-14 days. Use a waterproof cover when showering.
Do not wait until pain is severe before taking medication. Regular simple analgesia (paracetamol, ibuprofen if appropriate) is more effective than taking it only when needed.
This is usually 2 weeks after surgery. Sutures or clips will be removed if used.
Seek urgent advice if you develop increasing redness, warmth, swelling, discharge from the wound, calf pain or swelling (possible DVT), shortness of breath, or a temperature above 38°C.
Foot kept elevated. Crutches required. Outpatient wound check at 2 weeks.
Replaced cast or boot. Strict non-weight-bearing continues.
X-rays confirm bone healing. Gradual transition from partial to full weight-bearing in a walking boot.
Transition to supportive shoes, often with custom orthotics. Physiotherapy to rebuild strength and balance.
Continuing improvement. Final outcome assessed at 12 months. Most patients return to walking and many low-impact activities.
Yes. Most patients walk comfortably after recovery, though high-impact activity may be limited depending on the procedures performed.
Many patients continue to use supportive insoles long-term to maintain the correction.
Desk work: 6-12 weeks. Standing work: 4-6 months. Heavy manual work: often longer, may require redeployment.
For right-sided surgery, typically 10-12 weeks. Left side in an automatic car, around 6-8 weeks if comfortable.
Plain-English answers to the things people most often ask, grounded in published guidance. Tap a question to open it.
It is usually a combination tailored to you, which can include a tendon transfer, reshaping bone cuts (osteotomies) and sometimes fusing a joint.
The aim is a balanced, better-aligned and less painful foot.
Surgery is for painful, progressive or rigid flat foot that has not responded to insoles, bracing and other non-surgical care.
It is a considered step because recovery is long.
Usually a general or spinal anaesthetic with a nerve block for pain relief.
Your anaesthetist will discuss the options.
Expect a cast or boot and a period of limited weight-bearing, followed by months of rehabilitation.
Plan ahead for help during the early non-weight-bearing weeks.
Arrange significant help at home, crutches or a frame, and time off, and plan for a spell of being off the foot.
Getting the home ready in advance makes a big difference.
Wound problems, a temperature, or calf or chest symptoms need prompt help.
Elevation helps reduce swelling and risk.