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Feets, Don't Fail Me Now

Early surgery to lift fallen arches can forestall later debilitation

SUNDAY, July 8, 2001 (HealthDayNews) --Once the arch of a foot begins to fall, it's a painful downhill path that leads to the arch's eventual collapse. And that can cause debilitating arthritis for many adults in both the foot and ankle.

But recent studies suggest that pain can be avoided by catching the problem early enough and proceeding with reconstructive surgery.

Clinical studies show that patients who have early surgery fare far better than those who wait, according to research presented at a recent meeting of the American College of Foot and Ankle Surgeons.

"As many as three in four adults with this condition will eventually need surgery, so it's better to have the joint preservation procedure done before your arch totally collapses," says Dr. Byron Hutchinson, a foot surgeon at the Highline Foot and Ankle Clinic in Seattle.

Dr. Glenn B. Pfeffer, a San Francisco orthopedic surgeon, says it's important to note that many adults have a relatively benign condition in which both feet are "flat," and treatment of any sort is usually not required.

"Surgery is only usually recommended for cases in which the disease of the major tendon on the inside of the ankle -- usually on just one foot -- causes pain. That can lead to one foot having a collapsed arch," Pfeffer says.

"It's a very serious problem and it's true that the earlier it's treated the better," he adds. "No question."

So at what point are suffers good candidates for surgery? Hutchinson says there are certain tip-offs.

"We know that surgical intervention for adult-acquired flat feet is appropriate when there is pain and swelling and the patient notices that one foot looks different than the other because the arch is collapsing."

The surgery stabilizes the condition and can prevent further problems.

Collapsed arches in adults are caused by progressive lengthening of the tendon in the muscle that runs from the back of the knee to the arch.

The tendon is responsible for maintaining the arch in the foot. When inflamed or stretched, the tendon loses its ability to support or hold up the arch, and this results in pain from the inside of the ankle to the arch area.

The condition is more common in those who are overweight or maintain sedentary lifestyles.

"If you're developing an acquired flat foot on one side, be careful," says Pfeffer. "Because that's a serious orthopedic problem."

What To Do: Visit the American Orthopaedic Foot and Ankle Society for more information on caring for your feet.

SOURCE: Interviews with Byron Hutchinson, D.P.M., foot surgeon, Highline Foot and Ankle Clinic, Seattle; Glenn B. Pfeffer, M.D., orthopedic surgeon, San Francisco, Calif.; press release from the American College of Foot and Ankle Surgeons
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