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Pes planus

Alternative Names:

Pes planovalgus; Flat feet; Fallen arches; Pronation of feet

Treatment:

Flexible flat feet that are painless do not require treatment. If pain due to flexible flat feet occurs, an orthotic (arch supporting insert in the shoe) can bring relief. With the increased interest in running, many shoe stores carry shoes for normal feet and pronated feet. The shoes designed for pronated feet make long distance running easier and less tiring as they correct for the positional abnormality.

Rigid or painful flat feet require the evaluation of a health care provider. The exact treatment depends on the cause of the flat feet. For tarsal coalition, treatment starts with rest and possibly casting.

If this fails to improve the pain, surgery may be necessary to either resect the fused bone or actually completely fuse several bones in a corrected position. For problems with the posterior tibial tendon, treatment may start with rest, anti-inflammatory medications, and shoe inserts or ankle braces.

In more advanced cases, surgery may be necessary to clean the tendon, repair the tendon, or actually fuse some of the joints of the foot in a corrected position in very advanced cases.

Expectations (prognosis):

Most cases of flat feet are painless and no problems are to be expected. The prognosis of painful flat feet again depends on the cause of the condition. Usually treatment is successful, regardless of the cause.

If a fusion is required then there is some loss of ankle motion, especially turning the foot inward and outward, but otherwise patients with fusions report tremendous improvement in pain and function.

Complications:

Flat feet are not really associated with any complications except pain. Some causes of flat feet can be successfully treated without surgery if caught early, but occasionally, surgery is the last option to relieve pain.

While usually successful, surgery sometimes does not result in satisfactory results for all patients. Some have persistent pain and other possible surgical complications include infection and failure of fused bones to heal.

Calling your health care provider:

Call your health care provider if you experience persistent pain in your feet or your child complains of foot pain or lower leg pain.

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