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  • Tolgay Şatana

Flat Insoles Treatment: Sinus Tarsi Wedge

Before giving information about flatfoot treatment, let's answer the questions "What is Flat Insoles and What are the Effects on the Skeletal System".

It can be congenital or acquired.

Flat foot is the foot sitting on the ground with a large surface as a result of the loss of the arch of the foot. This situation causes the force that creates the spinning wheel mechanism by spreading to three different points like the stool foot during the transfer of weight, losing this effect on the wide base and causing the resultant force to move the mechanical axle to an unknown area without springing, the alignment is disrupted. The hip-spine-knees are positioned according to the resultant force-mechanical axis relationship.

Varus-Valgus internal or external rotations - Excessive lordosis-kyphosis occurs in the spine, posture deteriorates. Since the axis change will disrupt the joint mechanics, abrasions occur and become vulnerable to trauma, falls increase.

How is Flat Insoles Treatment Performed?

Congenital flat feet may require early surgery. In cases that do not require surgery, massage treatments and shoes with ankle support are given after walking. At the age of two years, axis corrective heel wedges can be added to shoes that support the arch and grip the heel. While it is ensured that the foot bones are in contact with the arch supports at certain angles until the age of six, when ossification is achieved, softer shoes can be used with exercises.

Arch support should be continued during the rapid growth period such as adolescence. After the growth is complete, the benefit of padded shoes decreases. If angular changes continue, surgery is considered.

Closed flatfoot surgery (Arthroereisis-Arthroerez) is one of the best options. Other options are fusing the foot bones to each other on the axis they should be (Triple Arthrodesis). The foot loses its elasticity, although the axes are straightened, movement becomes difficult when the spring is broken.

Acquired flatfoot is treated similarly at an early age. If there is tendon failure, it can be repaired. Wrong sideburns due to fracture are corrected. It usually requires surgical intervention.

Which Age Group Is Flatfoot Treatment Applied?

Different approaches are applied in all age groups. The application range of closed surgical methods such as arthroeresis may be 14-50 years. It can be applied in selected cases outside these limits. In arthroeresis surgery, a special screw is placed in the space adjacent to the joint of the bones forming the arch called sinus tarsi, allowing the bones to return to their normal axis relations without freezing.

Since the foot does not lose its flexibility after this procedure, the spring-spinning mechanism does not deteriorate, the walking mechanics are improved and the strength increases.

How Long Does The Flat-Foot Closed Surgery Treatment Take?

In 30-45 minutes, the surgery is completed bilaterally.

What is the Recovery Process After the Surgery?

It can be walked with a special walking boot for 3 weeks. During this period, a cane may be required. 3-6 shoes that cover the ankle with arch support are preferred. Exercises are started with soft walking shoes for 6-12 weeks.

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