Tendon Transfer Surgery for the Foot & Ankle in Michigan | Dr. Biernacki

Quick answer: Tendon Transfer Surgery Foot Michigan is a common foot/ankle topic that affects many patients. Effective treatment starts with a targeted diagnosis, conservative-first treatment, and escalation only when needed. We treat this regularly at our Howell and Bloomfield Township practices. Book online, or call (810) 206-1402.

Medically reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatric Surgeon — Balance Foot & Ankle, Howell & Bloomfield Township, MI. Last updated April 2026.

Tendon transfer surgery — in which a functioning tendon is rerouted from its original attachment point to a new insertion to compensate for the loss of a paralyzed or absent muscle — is an important but underappreciated reconstructive tool in foot and ankle surgery. It addresses the root cause of foot deformities that result from muscle imbalance: when one muscle group is absent or weakened (from neurological injury, trauma, or congenital condition), the antagonist pulls unchecked, causing progressive deformity. At Balance Foot & Ankle in Southeast Michigan, Dr. Tom Biernacki performs tendon transfer procedures in the context of comprehensive foot and ankle reconstruction.

Common Tendon Transfer Procedures

Posterior tibial tendon (PTT) transfer for drop foot: in patients with drop foot (weakness of dorsiflexion from peroneal nerve injury or CMT disease), the posterior tibial tendon is rerouted through the interosseous membrane from the medial to the anterior compartment and attached to the dorsum of the foot — converting a plantarflexor/invertor into a dorsiflexor. This restores active clearance of the foot during gait, eliminating the need for an AFO in appropriate patients. FHL (flexor hallucis longus) transfer for Achilles insufficiency: used in insertional Achilles pathology with tendon degeneration or for late-presenting ruptures with tendon deficit. The FHL passes behind the medial malleolus to the posterior calcaneus — its power and direction closely mimic the Achilles. Most patients have minimal FHL loss as the FHL flexion arc is replaced by FDL. PTT transfer for lateral instability: used in neurological conditions (CMT, post-polio) where chronic inversion deformity has caused recurrent lateral ankle sprains uncontrollable with bracing. Flexor-to-extensor tendon transfer for hammertoe: the FDL (long flexor) of an affected toe is divided and rerouted over the top of the toe to the extensor apparatus — corrects a flexible hammertoe by converting the deforming force into a correcting force (Girdlestone-Taylor transfer).

Patient Selection and Outcomes

Tendon transfer success depends critically on: the donor tendon having sufficient excursion and strength (typically grade 4–5 MRC) to perform its new function; the deformity being correctable or corrected simultaneously (a tendon transfer into a rigid deformity doesn’t work); the absence of significant spasticity (spastic muscles don’t respond predictably to transfer); and appropriate rehabilitation to teach the patient the new motor pattern (the brain must re-learn to activate a muscle in its new role). Most tendon transfers in appropriately selected patients produce excellent, durable results — but the rehabilitation phase of learning to use the transferred tendon in its new role is essential and takes 6–12 months.

Frequently Asked Questions

Complex foot deformity from muscle imbalance or nerve injury may benefit from tendon transfer. Contact Balance Foot & Ankle in Southeast Michigan for hands-on exam plus imaging when needed with Dr. Biernacki.

Visit Balance Foot & Ankle — Same-Day Appointments Available

Our podiatry team serves patients throughout Michigan including Howell, Brighton, and Bloomfield Township. If you’re dealing with heel pain, ingrown toenails, or a foot injury, we have same-day appointment availability.

Frequently Asked Questions

When should I see a podiatrist?

If symptoms persist past 2 weeks, affect your normal activity, or are accompanied by red-flag symptoms (warmth, redness, swelling, inability to bear weight).

What does treatment cost?

Most diagnostic visits and conservative treatments are covered by Medicare and major insurers. Out-of-pocket costs vary by your specific plan.

How quickly can I get an appointment?

Most non-urgent cases see us within 5 business days. Urgent cases (sudden pain, possible fracture) typically same or next business day.

More questions patients ask

What is tendon transfer surgery for the foot?

See our full guide from Dr. Tom Biernacki DPM at Balance Foot & Ankle, Howell & Bloomfield Township, MI.

What conditions require tendon transfer surgery?

See our full guide from Dr. Tom Biernacki DPM at Balance Foot & Ankle, Howell & Bloomfield Township, MI.

What is recovery like after foot tendon transfer surgery?

See our full guide from Dr. Tom Biernacki DPM at Balance Foot & Ankle, Howell & Bloomfield Township, MI.

When should I see a podiatrist about tendon transfer surgery?

See Dr. Tom Biernacki at Balance Foot & Ankle — same-day appointments. Call (810) 206-1402. Howell & Bloomfield Township, MI.

Does insurance cover foot tendon transfer surgery?

Most PPO and Medicare plans cover medically necessary foot care. We accept BCBS and most Michigan insurers. Call (810) 206-1402.

Still have a question about coverage or cost? Book online and we will check your benefits before your visit: Book in Howell · Book in Bloomfield Township. Prefer to talk it through first? Call (810) 206-1402.