Name of the Procedure:

Incision, flexor tendon sheath, wrist (e.g., flexor carpi radialis)

Summary

This procedure involves making an incision into the sheath surrounding the flexor tendons in the wrist, such as the flexor carpi radialis tendon, to relieve pressure or remove any obstructions.

Purpose

The procedure addresses issues like tenosynovitis (inflammation of the tendon sheath) or constriction that can cause pain, swelling, and limited wrist movement. The goal is to relieve symptoms, restore function, and prevent further tendon damage.

Indications

• Persistent pain in the wrist despite conservative treatments.
• Swelling and tenderness along the flexor tendons.
• Limited range of wrist movement.
• Indications of infection or nodules within the tendon sheath.
• Specific conditions such as De Quervain's tenosynovitis or trigger finger.

Preparation

• Fasting may be required if general anesthesia is used.
• Patients may need to stop certain medications, such as blood thinners, as advised by their doctor.
• Pre-operative assessments including blood tests and imaging (e.g., MRI or ultrasound) of the wrist.

Procedure Description

1. The patient is positioned comfortably, usually lying down with the arm extended.
2. The affected area is cleaned and sterilized.
3. Local or general anesthesia is administered.
4. The surgeon makes an incision over the affected tendon sheath.
5. The sheath is opened, and any constrictions, inflammations, or nodules are addressed.
6. The incision is closed with sutures, and a sterile dressing is applied.

Tools used may include scalpels, forceps, and specialized surgical scissors.

Duration

The procedure typically takes about 30 minutes to an hour, depending on the complexity.

Setting

Performed in an outpatient clinic, hospital operating room, or surgical center.

Personnel

• Orthopedic surgeon or hand surgeon.
• Surgical nurses.
• Anesthesiologist or nurse anesthetist (if general anesthesia is used).

Risks and Complications

• Infection.
• Bleeding.
• Nerve damage.
• Tendon rupture or re-inflammation.
• Anesthetic complications.

Benefits

• Relief from pain and inflammation.
• Improved wrist function and range of motion.
• Prevention of further tendon damage.

Benefits are usually realized within a few weeks post-procedure, following proper rehabilitation.

Recovery

• Keep the surgical site clean and covered.
• Follow post-operative instructions on wound care and medication.
• Gradual return to normal activities over 2-6 weeks.
• Physical therapy may be recommended.
• Follow-up appointments to monitor healing.

Alternatives

• Non-surgical treatments such as splinting, physical therapy, corticosteroid injections.
• Pros: Non-invasive, lower risk.
• Cons: May not provide long-term relief, possibility of recurring symptoms.

Patient Experience

Patients may feel discomfort during anesthesia administration but should not feel pain during the procedure. Post-procedure, mild to moderate pain can be managed with prescribed pain relievers. Swelling and stiffness may be experienced, improving gradually with rest and rehabilitation.