The posterior tibial tendon, located at the back of the foot and ankle, can tear or even rupture, causing problems in the foot and ankle. This tendon is responsible for maintaining the arch of the foot and to mechanically lock the hindfoot when walking; if it’s damaged, it can cause the foot to become flexible and flat. When the tendon is severely torn or ruptured, it typically cannot be repaired and must be replaced with a tendon transfer.
Additional procedures may also be necessary, depending on the specifics of the injury, to provide enough support. These procedures are designed to strengthen and straighten the foot. They may include a calcaneus osteotomy (cutting on the heel bone), a cuneiform osteotomy (bone cut in the middle of the foot), and lengthening of the Achilles tendon. Not all patients require these additional procedures, and some can have successful surgeries without them. In severe cases, select joints are fused or healed together in order to support the foot and prevent the deformity from reoccurring.
Flatfoot Reconstruction Recovery
After a posterior tibial tendon reconstruction surgery, the patient must avoid putting weight on their foot for at least six weeks. Still, the recovery period can be longer depending on the specific procedures performed. Using crutches, a walker, a wheelchair, or a scooter can be helpful during the healing process. Initially, a hard plaster bandage immobilizes the foot for the first two weeks. Then the patient is typically fitted for a removable boot during the first follow-up appointment, usually two weeks after surgery. Physical therapy is often recommended after surgery to help the patient regain strength and movement in the ankle. Again, the length of recovery varies depending on the procedures performed, but soreness and aching can be expected for up to six months, and it may take more than nine months to regain full movement and strength in the ankle.
During the first week after surgery, the patient must avoid walking and keep their foot wrapped in a plaster splint. They should also use ice, elevate the foot, and take pain medication as needed.
Between weeks two and six, the patient will have a follow-up appointment with the surgeon, during which X-rays will be taken, the dressing will be changed or removed, and a hard short leg cast will be fitted to support the hindfoot. Weight-bearing can begin with the surgeon’s approval after at least six weeks.
Between weeks six and nine, the patient can put full weight in a cast or boot and start physical therapy. At week twelve, the boot or cast will be removed, and the patient will return to walking in their shoes.
Flatfoot reconstruction is a complex and multifaceted process that typically requires a range of procedures to achieve full reconstruction. If a diagnosis has been made and surgical repair is deemed necessary, the skilled team at Flint Foot and Ankle is equipped to provide expert assistance. Our team is trained in a variety of surgical procedures specifically designed to address this type of injury and help our patients achieve optimal ankle and foot health