26449 Tenolysis, complex, extensor tendon, finger, including forearm, each tendon

Name of the Procedure:

Tenolysis, complex, extensor tendon, finger, including forearm, each tendon

Summary

Tenolysis is a surgical procedure aimed at freeing a tendon that has become stuck due to scar tissue or adhesions. This specific procedure focuses on the extensor tendon in the finger and forearm.

Purpose

Tenolysis is performed to restore normal tendon movement and function. It addresses issues of restricted tendon motion which can result in limited finger and hand function. The goal is to improve range of motion, dexterity, and overall hand performance.

Indications

• Limited motion in the finger or hand due to scar tissue.
• Stiffness or immobility following hand or forearm injuries.
• Failed conservative treatments like physical therapy.
• Compromised tendon movement affecting daily activities or occupational tasks.

Preparation

• Fasting for at least 8 hours before the procedure.
• Adjustments in routine medications as directed by the physician.
• Preoperative diagnostic tests such as X-rays or MRI to assess the extent of tendon adhesions.

Procedure Description

1. The patient is given regional or general anesthesia.
2. An incision is made over the affected area to expose the extensor tendon.
3. The surgeon carefully removes the scar tissue and adhesions surrounding the tendon, ensuring not to damage the tendon itself.
4. Once the tendon is freed, the incision is closed with stitches.
5. A sterile dressing is applied.

Duration

The procedure typically takes around 1 to 2 hours, depending on the extent of adhesions.

Setting

Tenolysis is usually performed in a hospital or an outpatient surgical center.

Personnel

• Orthopedic or hand surgeon
• Surgical nurses
• Anesthesiologist or nurse anesthetist

Risks and Complications

• Infection at the surgical site
• Bleeding
• Nerve injury causing numbness or weakness
• Tendon re-adhesion
• Scarring
• Reduced range of motion if the procedure is not fully successful

Benefits

• Improved tendon mobility
• Enhanced function of the finger and hand
• Greater range of motion and strength
• Return to normal activities and improved quality of life

Recovery

• Initial immobilization using a splint or cast.
• Pain management with prescribed medications.
• Physical therapy to improve strength and flexibility.
• Regular follow-up appointments to monitor progress.
• Complete recovery may take several weeks to months.

Alternatives

• Conservative treatments like physical therapy and occupational therapy.
• Non-surgical interventions such as splinting, corticosteroid injections, or anti-inflammatory medications.
• Other surgical options like tendon transfer or reconstruction in more severe cases.

Patient Experience

• Patients may feel discomfort or mild pain post-operatively, managed by prescribed pain relievers.
• Swelling and bruising are common during the initial healing phase.
• Physical therapy might involve some soreness but is essential for optimal recovery.
• Gradual improvement in tendon movement and hand function over weeks to months.