Foot and ankle
Flatfoot reconstruction
Combines tendon, ligament and bone procedures to improve the arch, alignment and weight-bearing mechanics.
General guidance
When it may be considered
- pain and fatigue when walking
- progressive deformity
- associated instability or osteoarthritis
Individual decision
How suitability is determined
The strategy depends on the flexibility of the deformity, the posterior tibial tendon, hindfoot alignment and which joints are affected by osteoarthritis.
An abnormal scan alone is not an indication for surgery. The symptoms, clinical examination, progression and the patient's goals must be considered together.
Surgical plan
Decisions that tailor the procedure
- flexibility of the deformity and the condition of the joints
- function of the posterior tibial tendon and spring ligament
- joint-preserving osteotomies and tendon procedures
- selective fusions when the deformity is rigid or associated with osteoarthritis
Alternatives
What is discussed before surgery
Supportive footwear, insoles, bracing and physiotherapy may control a flexible deformity or delay surgery. A rigid deformity with osteoarthritis requires a different discussion from a flexible flatfoot.
Before the procedure
Preparation and safety
- prepare your home and arrange help for a period of restricted weight-bearing;
- control swelling, address any skin problems, optimise diabetes control and stop smoking before reconstruction;
- bring all investigation results, previous operative records and a complete list of medication;
- do not stop or change long-term medication without instructions from the medical team;
After the procedure
Rehabilitation
Immobilisation and protected weight-bearing may be required, followed by rehabilitation and footwear modification.
The exact protocol, permitted weight-bearing and follow-up schedule depend on the procedure performed and individual progress.
Informed consent
Risks and limitations
Possible complications include stiffness, recurrence, residual pain, problems with bone healing, infection and the need for revision surgery.
No procedure can guarantee complete pain relief or a return to a particular level of activity.
After surgery
Signs that require prompt medical assessment
- fever, discharge, spreading redness or worsening pain at the wound;
- sudden swelling of the calf, chest pain or difficulty breathing;
- uncontrolled pain, new numbness, or a change in the colour or temperature of the limb.
For severe symptoms or an emergency, call 112. The instructions given to you at discharge take priority over the general information on this page.
Editorial responsibility
Medically reviewed content
Dr. Răzvan Anițaș
Consultant orthopaedic and trauma surgeon; PhD in medical sciences
Last editorial update: 22 August 2026
Medical sources used for patient information
First step
Consultation, diagnosis and an individual treatment recommendation
This information does not replace a consultation. Surgery is recommended only after the individual benefits, alternatives and risks have been assessed.