Children often present to the podiatry office with their parents with a complaint of flat feet. This is a very common condition in children known as flexible flat foot or pes planus. During the first few years of life, a flatter type foot is normal in children. However, when the child is older than five, and has found that he/she is no longer keeping up with peers in sports or gym class, the flat feet become problematic.
A podiatrist utilizes X-rays and an examination to diagnosis the flat foot. X-rays will show a decrease in the arch height as well as changes to the child’s front part of the foot consistent with flat foot changes. Clinical examinations can demonstrate a flattened arch as well as a changes to the child’s heel bone. At this time, a conservative option for treatment for these children can be custom orthotic inserts for their shoe. This helps to support the arch, place the foot in a neutral position and slow progression of the deformities associated with flat feet.
Around age 8, children may complain of achiness or tiredness to their feet. They also feel that they are less able to keep up with their classmates. These children have outgrown their orthotics and their orthotics are no longer supporting their arch. At this time, surgical intervention may be necessary. There are different types of procedures used to correct flat feet. One procedure is known as the Subtalar Joint Arthroereisis. The subtalar joint arthroereisis has been found to be successful and helps to limit the motion in the subtalar joint which is at the root of the flat foot deformity in may cases.
The surgical procedure for the subtalar joint arthroereisis involves inserting an implant into the sinus tarsi, which is a tunnel between the ankle bone and the heel bone. The overall time involved in the procedure is approximately 30 minutes and a small (one centimeter) incision is needed on the outside of the foot. The child is able to walk on the foot using a boot or walking cast. The subtalar implant is typically left in place and does not need to be removed.
The subtalar joint arthroereisis is just one type of procedure utilized to correct the flat foot. This can be used in both children and adults as well with certain types of issues. The procedure is quick with a faster recovery time. Patients are generally happy with the procedure and have found to do well overall. Studies suggests patient satisfaction rates of between 79% to 100% with the arthroereisis procedure.