25109 Excision of tendon, forearm and/or wrist, flexor or extensor, each

Name of the Procedure:

Excision of tendon, forearm and/or wrist, flexor or extensor, each. Medical term: Tenolysis or Tendon Release Surgery.

Summary

This surgical procedure involves the removal of a damaged or diseased tendon in the forearm or wrist. Tendons are the fibrous tissues that connect muscles to bones, and this procedure helps restore function and reduce pain.

Purpose

This procedure addresses conditions such as tendon injuries, chronic tendonitis, or adhesions limiting tendon movement. The goal is to alleviate pain, improve mobility, and restore normal function to the affected limb.

Indications

• Persistent pain and swelling in the forearm or wrist.
• Limited range of motion or difficulty moving the wrist/forearm.
• Diagnosis of tendonitis, tendon tears, or adhesions not responsive to conservative treatments.
• Failed previous treatments, including physical therapy or medications.

Preparation

• The patient may need to fast for several hours before the procedure.
• Discontinuation of certain medications, such as blood thinners, as advised by the doctor.
• Pre-operative assessment, including imaging studies (X-ray, MRI) and blood tests.
• A thorough medical evaluation to assess anesthesia suitability.

Procedure Description

1. Anesthesia: The patient is administered local, regional, or general anesthesia.
2. Incision: A small incision is made over the affected tendon in the wrist or forearm.
3. Tendon Exposure: The surgeon carefully exposes the tendon.
4. Excision: The damaged or scarred portion of the tendon is precisely removed.
5. Repair: If needed, the tendon is repaired or sutured to enhance function.
6. Closure: The incision is closed with sutures, and a sterile dressing is applied.

Equipment used includes surgical knives, scissors, forceps, and specialized tendon instruments.

Duration

The procedure typically takes about 1 to 2 hours, depending on the complexity and extent of tendon damage.

Setting

This surgery is usually performed in a hospital or surgical center, often on an outpatient basis.

Personnel

• Orthopedic or hand surgeon.
• Anesthesiologist or nurse anesthetist.
• Surgical nurses and technicians.

Risks and Complications

• Infection
• Bleeding
• Nerve damage
• Stiffness or limited range of motion
• Anesthesia-related risks
• Recurrence of tendon issues

Benefits

• Pain relief
• Improved mobility and function of the wrist and forearm
• Enhanced quality of life
• The benefits are often experienced within a few weeks post-surgery, following a recovery period.

Recovery

• Initial post-operative pain and swelling managed with medications and ice.
• The affected limb may be immobilized with a splint or cast initially.
• Physical therapy is crucial for regaining strength and flexibility.
• The full recovery period ranges from several weeks to a few months.
• Follow-up appointments to monitor healing and progress.

Alternatives

• Physical therapy and exercise regimens
• Corticosteroid injections
• Oral anti-inflammatory medications
• Alternative surgeries, such as tendon repair without excision

Patient Experience

During the procedure, the patient will be under anesthesia and should not feel pain. Post-surgery, discomfort and stiffness are common, but can be managed with pain relief measures. Physical therapy will play a significant role in ensuring a smooth and effective recovery.