Restoring Balance
When a tendon has failed - most commonly the posterior tibial in adult-acquired flatfoot, but also the peroneals, anterior tibial, or Achilles - transferring an adjacent functioning tendon can restore the lost mechanical force and re-balance the foot.
Procedures
- FDL (flexor digitorum longus) transfer to navicular for PTTD
- Peroneal tendon repair and transfer for chronic peroneal injury
- FHL transfer for Achilles reconstruction
- Combined transfers with osteotomy or fusion for complex deformity
Recovery
Tendon healing requires protected weight-bearing in a boot or cast for 6–8 weeks, structured rehabilitation, and a return to function over 4–6 months. Outcomes are highly dependent on patient selection and concurrent bony correction when needed.