Performed by – David Hinsley, Ngwe Phyo, Nick Ward

Flat feet are common with 30% of the population having a flexible flatfoot (ie one that will correct into a normal shape, with a medial longitudinal arch, on tip-toe standing). Children may have this problem but frequently have no problems with normal activities and consequently can be left alone. Occasionally such a foot may ache with impact activities, and an insole may help with this symptom. The insole will not however permanently alter the shape of the foot. Most adults who grow up with flat feet manage perfectly well with normal shoes during all activities.

A fixed flat foot deformity (which does not correct on standing on tip-toes) is nearly always pathological and is more likely to require surgical intervention. A foot that was normal shape, but has become flat, is also pathological.

The feet are clinically examined and x-rayed to assess whether there is a requirement for orthotics, physiotherapy, or surgery, but the majority of flatfeet will require no treatment. If surgical treatment is required further scans (CT or MRI) may be undertaken to gain more information and allow surgical planning.

The type of surgery varies depending on the cause of the deformity, but can involve excising a coalition (an abnormal connection between bones), osteotomies (cutting and moving bones), tendon transfers, and fusing joints.