Flatfoot Reconstruction — (Tendon Transfer / Calcaneal Osteotomy / Fusion)

Lahey Hospital & Medical Center · M.J. Lobo MD, J. Salley DPT

Weight-Bearing

NWB in splint 0-4 wks; progressive WB in CAM boot wks 4-12 (start 20 lbs, advance 20 lbs every 4 days to FWB); FWB in supportive shoe after

Key Restrictions

No PROM until month 3; progress AROM eversion carefully; treadmill only after stair negotiation normalized; full recovery up to 1 year

Timeline & Phases

Phase I (0-4 wks): NWB splint in DF, elevation 50 min/hr, hip/knee AROM, toe AROM, 4-way ankle isometrics in cast; Phase II (4-12 wks): progressive WB in CAM boot, AROM ankle/hindfoot, gentle gastroc/soleus stretching, closed chain, double-limb proprioception, foot doming; Phase III (12-24+ wks): SLS, AAROM/PROM ankle, resisted theraband, eccentric gastroc, single-limb heel raises, plyometrics if appropriate

Notes

Covers multiple procedures: FDL tendon transfer (augments/replaces PTT), gastrocnemius recession, posterior calcaneal osteotomy (medial slide), anterior calcaneal osteotomy (lateral column lengthening), first TMT fusion and/or navicular-cuneiform fusion.

Surgeon / Author

M.J. Lobo MD, J. Salley DPT

Published

2020-01