How effective is tendon transfer surgery for clubfoot?

Clubfoot can place the foot in an inward, downward, or stiff position. A tendon transfer moves the attachment or route of a working tendon so its pull supports a more balanced foot position. This can reduce an uneven turning force and help the sole contact the ground more evenly. It does not lengthen every tight structure or replace the need to assess the bones and joints.

The expected benefit is better alignment and control, not simply a change in appearance. Flexible feet often respond differently from rigid or severely deformed feet. Bracing, stretching, strengthening, and gait practice remain part of care. Recurrence, residual stiffness, weakness, altered sensation, or discomfort can still occur, particularly when the underlying muscle imbalance persists.

The assessment should cover foot flexibility, ankle movement, muscle strength, walking pattern, skin condition, and any previous treatment. After surgery, protect the transfer in the cast or brace for the advised period and avoid putting extra force through it before healing. Keep follow-up visits, use prescribed footwear or orthoses, and practise the exercises that retrain the tendon in its new direction.

Contact the care team urgently if the cast becomes tight or wet, toes become blue, cold, numb, or increasingly painful, or swelling is rapidly worsening. After the cast is removed, report a sudden return of the foot turning inward, a new inability to bear weight, wound drainage, or fever.

Ask which tendon will be transferred, whether the foot is flexible enough, how long protection will last, and what walking changes are realistic. Discuss the need for bracing and how recurrence or residual stiffness will be monitored.