Occupational Outcomes of Reconstructive Surgery for Adult Acquired Flatfoot Deformity.

Abstract

Reconstruction of a symptomatic adult flatfoot is an involved operation with a long recovery period. No previous studies have looked at the occupational or functional results of athletically active patients who have undergone this surgery. In the U.S. Military, the rates of return to unrestricted active duty are unknown. A retrospective review of all active duty military patients who underwent a reconstructive surgery for adult acquired flatfoot surgery at a single institution from January 2001 to 2015 was performed. 50 patients met inclusion criteria. 28 of 50 patients (56%) remained on active duty with permanent duty restrictions, and only 2 of 50 patients (4%) returned to full duty without restrictions. 20 of 50 (40%) patients underwent a Medical Evaluation Board to separate from the military. A difference was noted in terms of the hindfoot realignment procedure performed: the probability of a Medical Evaluation Board is higher for those patients who had a lateral column lengthening procedure as compared to those who were treated with a medializing calcaneal osteotomy. The sample size is the largest study to date of young active patients who underwent surgical correction for symptomatic pes planus. The results demonstrate that a service member with symptomatic pes planus requiring surgery faces a 96% chance of failure to return to his or her preinjury level of function. Although some patients (56%) were able to remain on active duty with restrictions, there is a 40% chance that service members will face separation from the military because their foot pain despite a year of surgery and recovery. Furthermore, patients treated with a lateral column lengthening had a higher probability of being medically discharged than those who had a medializing calcaneal osteotomy.