Flatfoot ( pes planus )

Updated: Sep 2, 2021

Flat foot deformity is a progressive deformity of the foot. 20-30%of the population suffers from this but not everyone is symptomatic. The chief complaint of the patient is that they have “fallen arches”. This is associated with foot, ankle and even leg pain in severe cases. This is mainly a biomechanical condition in which the subtalar joint overpronates resulting in the collapse of the medial longitudinal arch.

This collapse of the medial longitudinal arch of the foot puts the other joints of the foot under stress. This stress eventually leads to arthritis and a rigid deformity. It also stretches the posterior tibial tendon which leads to its degeneration.


X-rays are taken in the office to identify the extent of the disease. These X-Rays should be weight bearing. Oten an MRI is required to assess the the ligamentous and tendinous structures.

Early identification and management of this condition is very important. Almost always, patients have a tight heel cord. Custom orthotics, shoe gear modification and stretching exercises of the heel cord are often all that is needed in the initial stages. Often this is not enough and does not alleviate the symptoms which then requires surgical correction of the deformity. Osteotomies in the bones of the foot are performed and the bones are repositioned to create and arch. The achilles tendon is also lengthened surgically in most cases.



If the patient presents with arthritis and has a rigid deformity the procedure of choice is arthrodesis. The subtalar joint along with the Talo-navicular and the calcaneo-cuboid joints are fused to recreate the arch and eliminate the pain. Restoring the arch and the natural angulation is of paramount importance. Postoperatively patients are placed in a Cast or CAM walker with non weight bearing for 4-6 weeks.