What to expect from tendon transfer surgery for clubfoot

Clubfoot can leave the foot turned inward or pointed downward, sometimes with muscle imbalance that persists after earlier treatment. In a tendon transfer, the surgeon moves a tendon and its attachment so its pull supports a more useful foot position. The tendon must still have enough strength and a suitable path for the planned job.

A cast or splint commonly protects the foot while the transferred tendon heals in its new position. At first, walking may be restricted. Later therapy focuses on ankle movement, balance, calf and foot strength, and learning to use the tendon’s new action.

Prepare a safe home setup with supplies within reach and a plan for school, work or childcare. After surgery, keep the cast dry, elevate the foot when it is swollen and use crutches or other support exactly as demonstrated. Do not place weight through the foot until the surgeon permits it. Once the cast is removed, attend therapy and practise the prescribed movements; the transferred tendon needs repetition to develop coordinated control.

Wear any later brace or supportive shoe as directed. Check the skin around the cast and report rubbing rather than padding or altering the cast yourself.

Call the treating team for a cast that becomes too tight or wet, numb or unusually pale toes, worsening swelling, foul smell, drainage, fever or pain that is not controlled by the agreed plan. Seek urgent care for severe calf swelling, chest pain or difficulty breathing. A fall, broken cast or sudden change in foot position should be assessed promptly.

Ask which tendon will be transferred and what movement it is intended to improve. Confirm weight-bearing limits, cast and brace changes, bathing arrangements, therapy milestones, footwear advice and the expected timing for school, work, driving or sport.