Name of the Procedure:

Tenolysis, flexor or extensor tendon, forearm and/or wrist, single, each tendon

Summary

Tenolysis involves the surgical release of a tendon that has become adhered to surrounding tissue, hindering its movement. This procedure focuses on either the flexor or extensor tendons in the forearm or wrist and is performed on a single tendon at a time.

Purpose

Tenolysis addresses conditions where a tendon is bound by scar tissue, causing pain and restricted movement. The goal is to restore the tendon's normal gliding function, thereby improving mobility and reducing discomfort.

Indications

• Restricted range of motion despite physical therapy
• Pain or swelling in the forearm or wrist
• Previous surgery or injury leading to scar tissue formation
• Confirmed tendon adhesion through diagnostic imaging

Preparation

• Fasting may be required if general anesthesia is used.
• Adjustments to certain medications, particularly blood thinners.
• Preoperative imaging tests such as MRI or ultrasound to evaluate the extent of adhesion.
• Medical history review and physical examination.

Procedure Description

1. Anesthesia: Local, regional, or general anesthesia is administered.
2. Incision: A small incision is made over the affected tendon.
3. Release: The surgeon carefully separates the tendon from the surrounding scar tissue.
4. Assessment: The range of motion is evaluated to ensure the tendon is free.
5. Closure: The incision is closed with sutures, and a sterile dressing is applied.

Tools include scalpels, scissors, retractors, and sometimes specialized instruments to aid in freeing the tendon.

Duration

Typically, the procedure takes about 1 to 2 hours.

Setting

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

Personnel

• Surgeon
• Surgical nurse
• Anesthesiologist or nurse anesthetist

Risks and Complications

• Infection at the incision site
• Bleeding or hematoma formation
• Damage to nearby nerves or blood vessels
• Recurrence of tendon adhesion
• Reduced range of motion or strength

Benefits

The expected benefits include restored range of motion, reduced pain, and improved function of the affected tendon. Improvements can typically be noticed within a few weeks to months after surgery.

Recovery

• Keep the surgical area clean and dry.
• Follow specific instructions for wound care and physical therapy.
• Expect a gradual return to normal activities over several weeks.
• Attend follow-up appointments to monitor healing.

Alternatives

• Non-surgical options such as physical therapy, anti-inflammatory medications, or corticosteroid injections.
• Pros: Less invasive, lower immediate risk.
• Cons: May not resolve severe adhesions, longer duration to see improvement.

Patient Experience

During the procedure, the patient may be under sedation or anesthesia and should not feel pain. Post-procedure, discomfort and swelling are common and can be managed with prescribed pain medications and ice packs. Physical therapy plays a crucial role in full recovery.