Occupational Outcomes of Reconstructive Surgery for Adult Acquired Flatfoot Deformity

Area of Science:

• Orthopedic Surgery
• Military Medicine
• Podiatry

Background:

• Adult acquired flatfoot reconstruction is complex with prolonged recovery.
• Previous studies lack data on functional outcomes in athletic populations.
• Return-to-duty rates after flatfoot surgery in the U.S. Military are unknown.

Purpose of the Study:

• To evaluate occupational and functional outcomes of reconstructive surgery for symptomatic adult flatfoot in active duty military patients.
• To determine return-to-duty rates and identify factors influencing outcomes.

Main Methods:

• Retrospective review of active duty military patients undergoing adult acquired flatfoot reconstruction.
• Study period: January 2001 to December 2015 at a single institution.
• Inclusion criteria: 50 patients meeting specific surgical and active duty status.

Main Results:

• Only 4% of patients returned to full duty without restrictions.
• 56% remained on active duty with permanent restrictions; 40% faced medical separation.
• Lateral column lengthening procedures were associated with a higher likelihood of medical discharge compared to medializing calcaneal osteotomy.

Conclusions:

• Surgical correction for symptomatic pes planus in service members has a 96% chance of failure to return to preinjury function.
• A significant portion (40%) of military personnel face separation due to persistent foot pain.
• Surgical technique, specifically lateral column lengthening versus medializing calcaneal osteotomy, impacts the probability of medical discharge.