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02 Flatfoot / Pes planovalgus

With a flat foot, the arch of the foot is lowered. The heel is then often bent into the X position. We recommend conservative treatment as a first step. If this does not work sufficiently, we suggest surgery.


The arch of the foot can drop in the course of life, usually the heel then bends into the X position. This is due to age-related fatigue of ligaments and tendons, mainly affecting the tibialis posterior tendon. The extent varies, from a slight tendon overload to a complete collapse of the arch of the foot. As a result, altered forces act on the foot joints, so that tendons and ligaments are additionally overloaded and arthrosis can develop.

In the early stages of flatfoot, you can delay its progression by training the arch of the foot. Shoe inserts in strong shoes can also help support the arch and reduce pain.

Conservative treatment

We recommend fitting shoes and insoles as the first step, as this often leads to satisfaction. If surgery is necessary after all, we depend on a well-fitting, strong insole-capable shoe that you can wear after the plaster cast is removed. Thus, the purchase of an adapted shoe is not in vain in any case.

Surgical treatment

Pain or poor weight-bearing capacity of the foot, which cannot be improved by insoles, are good reasons for an operation. You should not wait any longer if the deformity of the foot affects the ankle joint. For this reason, we also make an x-ray of your ankle in order to be able to advise you in this regard.

There are a number of individual standard surgical steps, which we combine individually. In the early stages, the weakened tendon can be strengthened by repositioning another tendon. Weakened ligaments are sutured. The calcaneus can be moved from the X position to a better position. Destroyed joints should be straightened and fixed. Screws and plates hold the displacements or fusions, they usually do not need to be removed.

Correcting the foot by shifting the heel and tendon suture:

Correcting the foot by fusion of the hindfoot joints:

After the surgery

The hospital stay is about 4 days, after surgery plaster cast treatment is performed for 6 - 8 weeks. After that, the ability to walk is rebuilt in a removable boot. Even after the plaster cast has been removed, your walking ability is not unrestricted, as the capsules, tendons and ligaments often remain swollen and sensitive for 4 - 6 months. We recommend that you wear a stable shoe with a good insole for this period.

After extensive foot reconstruction, stop-and-go sports such as tennis, soccer, etc. are not recommended. Hiking, cycling, golf, fitness training or similar should be possible again. How quickly you achieve unrestricted pain-free weight-bearing after the operation depends on the individual and takes between 6 - 12 months. We advise you to have insoles fitted for sports after the operation, it will positively influence the resilience of your foot.

left: before the surgery / right: after surgery
left: before the surgery / right: after surgery

Watch the TV program with Dr. med. Hitz on flatfoot.

Schedule an appointment with us so we can find the best treatment option for you.


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