Many tendons in the foot can develop chronic inflammation and develop a lesion that will disrupt their function and cause pain. If conservative treatment is not effective enough, surgical treatment may be offered to restore the function of the tendon. The most effective techniques are tendon transfers. The defective tendon will then be "reinforced" by another tendon of the foot located nearby which has a function similar to the affected tendon. This technique is very effective in cases of chronic Achilles tendonitis associated with weakness or insufficiency of the Achilles tendon. The long flexor tendon of the big toe can be taken from the forefoot and transferred to the Achilles tendon, thereby restoring the optimal tension necessary for normal function of the tendon. In the case of a decompensated flat foot, the posterior leg tendon is often defective and can be strengthened by a transfer of the long flexor tendon from the toes. Tendon transfers are also very effective in the event of a neurological problem causing weakness or paralysis of certain tendons, in particular the extensor tendons of the foot, as is the case in a falling foot. Tendon transfers then correct the imbalance between the flexor tendons and the extensor tendons without, however, being able to restore normal function and the wearing of a stabilization splint often remains necessary.
This type of intervention requires a long period of rehabilitation in the postoperative phase. It takes a plastered immobilization period of six weeks, two weeks in total foot discharge and four weeks in partial load of 15 kg. From the 7th week a total load is authorized, and physiotherapy treatment is prescribed in order to improve muscle and joint function. Resumption of sports activities is then done gradually and the restoration of normal function of the injured tendon is possible in most cases. The function of the tendon taken for transfer is slightly reduced but does not affect the overall function of the foot.