Flatfoot in children doesn’t show right away. It takes about seven years for the foot to become fully developed; before that time period, the arches are still flat and developing. Usually, this requires no intervention and the foot is allowed to grow at its natural pace.
However – in some cases, the child might experience discomforting symptoms. This happens when the foot is severely deformed from a young age or has a congenital deformity like a tarsal coalition. In these cases treatment becomes imperative.
If a child has severely fallen foot arches and has difficulty bearing weight on the foot, they should be brought in for a thorough evaluation. A qualified foot doctor will determine the best treatment options for the child. After the age of seven, a further assessment of the foot will confirm whether intervention is necessary or not.
Flatfoot in a child is corrected through proper physiotherapy and orthotics. Sometimes the deformity could be severe enough to need a surgical repair.
Osteotomy (Traditional Flatfoot Surgery)
The standard flatfoot surgery in most parts of the world involves osteotomy that is to cut the bones or the foot and realign them to form a higher arch. In this procedure, a bone graft might also be required to realign the arch of the foot properly. The hip bone in a child is the number one choice to obtain a bone graft from.
Traditional flatfoot surgery is conducive, but it requires an extensive period of post-op rehabilitation. Patients take several months to recover before they can bear weight on their feet again. Because of these restrictions, traditional flatfoot surgery has been losing its popularity worldwide.
Minimally Invasive Flatfoot Surgery
To counter the prolonged recovery phase that came with traditional flatfoot surgery, modern physicians and surgeons are now gravitating towards a more minimally invasive approach. This surgical procedure is termed as arthroereisis and involves inserting a titanium implant through a small incision. This implant is placed in the sinus tarsi area, and it acts as an ‘internal splint’ to form a high arch from the inside.
The implant provides support to the ligaments as the foot grows with age. The rehabilitation and recovery of this type of surgery are faster with more effective results, bypassing the need for bone grafting completely.
For these reasons, arthroereisis has become the number one surgical correction of choice in children with severe flat feet.