Whilst a tendon transfer is not a new procedure, it is still a highly technical process. Once used for the treatment of polio, a modern tendon transfer is now performed by foot and ankle specialists. In foot and ankle surgery, a transfer is employed for patients who have painful flat feet. During the procedure, the transfer of the flexor digitorum longus tendon in the leg supplants the posterior tibial tendon. An osteotomy is then performed for heel realignment.
As stated, a tendon transfer is often used in cases of polio too. In many of these cases, patients suffered from a foot condition known as “foot drop”. To correct the problem, a functioning tendon was rerouted, which permitted ankle dorsiflexion, or a lifting of the foot. The use of a modern tendon transfer is commonly advised when the nerve has been damaged or there has been damage to the spine. In the case of spinal damage, a muscle is usually paralysed because of a damaged nerve.
A tendon transfer is also used in cases of tendon ruptures – injuries that are caused by rheumatoid disease. If the main nerve to the brachial plexus or upper limb is damaged, tendon transfers restore the movement in a muscle and joint. This kind of injury is often attributed to motorcycle mishaps. In cases of “adult-acquired posterior tibial tendon dysfunction” and “flat foot”, a detailed assessment must be made to determine whether fusion or a tendon transfer would be a better choice.
When performing a tendon transfer, the surgeon takes meticulous care to avoid cutting into any of the major nerves adjacent to the tendons. The tendon and supporting tissues are tensioned and balanced to round out the procedure.
If you opt for the surgery, you will spend approximately two nights in a hospital facility. Rest is required as well as foot elevation for approximately ten days. The patient mobilises using crutches when needed. A fibreglass cast, positioned below the knee, is worn for the first six weeks, and the patient must elevate their foot when possible. The cast is the taken off after that time.
Because of the nature of the surgery, physiotherapy is needed to maximise the results. Usually, patients use a walker boot that is made to safeguard the foot during the early part of the weight-bearing phase.
Office workers who have the surgery normally return to their jobs, with their feet in the plaster or in a walker boot, after about three weeks. If your job necessitates physical activity, you will need to wait about 12 weeks before you can return to the job.
The ankle may stiffen following a tendon transfer. As a result, physiotherapy plays an essential role in regaining mobility and ankle strength. Recovery rates vary for each person, but it usually takes about a year for full recovery and to be able to return to regular activities. However, with that being said, it is still worth the wait. If you need to have the surgery, it is advised you undergo the procedure, especially if your ankle or foot condition is interfering with your everyday activities.