The flexible flatfoot is a common condition seen in children causing collapse of the arch and subsequent pain with difficulty participating in certain activities. The majority of the time conservative treatment modalities with correctional orthotics are all that is needed to resolve acute symptoms. This 13-year-old patient, unfortunately, did not respond to conservative care and was taken to surgery to correct the underlying deformity with an achilles lengthening, subtalar arthroereisis, and opening wedge (cotton) osteotomy. After a couple months of recovery, she was back running around in shoes with no pain or discomfort.
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