Name of the Procedure:

Open Tenotomy, Flexor or Extensor Tendon, Forearm and/or Wrist, Single, Each Tendon

Summary

Open tenotomy involves surgically cutting a flexor or extensor tendon in the forearm or wrist. This procedure can be performed on one tendon at a time and is done through an open incision.

Purpose

The procedure aims to address tendon damage or deformities, relieve chronic pain, and restore function in the affected tendon. Conditions such as tendon contracture, tendonitis, or injuries may be treated with this surgery.

Indications

• Chronic tendon pain unresponsive to conservative treatments
• Deformities such as Dupuytren's contracture
• Tendon injuries or lacerations needing surgical repair
• Limited range of motion due to tendon abnormalities

Preparation

• Patients may need to fast for a specific period before the procedure.
• Medication adjustments might be required, especially blood thinners.
• Preoperative imaging tests like MRI or ultrasound to assess tendon condition.
• Pre-surgical consult to go over risks and expectations.

Procedure Description

1. Anesthesia is administered for pain management—usually local, regional, or general anesthesia.
2. An incision is made over the affected tendon area.
3. The surgeon carefully exposes and isolates the tendon.
4. The tendon is cut or released as necessary.
5. The incision is closed with sutures and bandaged.

Duration

The procedure typically takes about 30 to 60 minutes, depending on the specific circumstances.

Setting

It 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
• Bleeding
• Nerve damage
• Scarring
• Loss of tendon function
• Incomplete relief of symptoms

Benefits

• Relief from chronic pain
• Improved range of motion and tendon function
• Potential correction of deformities

Recovery

• Post-procedure immobilization of the forearm and wrist.
• Pain management with prescribed medications.
• Physical therapy to restore function and strength.
• Full recovery can take several weeks to months.
• Follow-up appointments to monitor healing.

Alternatives

• Non-surgical treatments like physical therapy, splinting, and corticosteroid injections.
• Minimally invasive procedures such as percutaneous needle tenotomy.
• The choice of treatment depends on the severity of the condition and patient-specific factors. Non-surgical options may offer temporary relief but may not be suitable for severe cases.

Patient Experience

• Patients may feel sore and experience some swelling and bruising post-surgery.
• Pain is managed with medications and rest.
• Physical therapy is critical for regaining strength and motion.
• Most patients can return to their daily activities gradually as healing progresses.