Name of the Procedure:

Tenotomy, percutaneous, single, each digit
Common Name: Percutaneous Tenotomy
Technical Term: Percutaneous Flexor Tenotomy

Summary

A percutaneous tenotomy is a minimally invasive procedure in which a small incision is made to release a tendon in a finger or toe. It's usually performed through a tiny needle puncture.

Purpose

This procedure addresses conditions that involve tendon tightness or deformities, such as trigger finger or claw toe. The goal is to improve function, reduce pain, and correct deformity.

Indications

• Chronic trigger finger or toe
• Severe stiffness or immobility of a finger or toe
• Flexor tendon contractures
• Failure to respond to conservative treatments like physical therapy or medication

Preparation

• Fasting might not be required, but follow specific instructions from your healthcare provider.
• Adjustments to anticoagulant or other medications may be necessary.
• Pre-procedure diagnostic tests could include X-rays or ultrasound of the affected digit.

Procedure Description

1. The targeted digit is cleaned and sterilized.
2. Local anesthesia is administered to numb the area.
3. A needle or small blade is inserted through the skin over the tendon.
4. The tendon is carefully cut or released through the percutaneous incision.
5. The incision is usually so small it may not require stitches.

Duration

The procedure typically takes about 15 to 30 minutes per digit.

Setting

• Outpatient clinic
• Surgical center

Personnel

• Orthopedic or hand surgeon
• Nurse or surgical assistant
• Anesthesiologist (if sedation is used)

Risks and Complications

• Common: Minor bleeding, swelling, infection
• Rare: Nerve damage, incomplete release of the tendon, need for additional surgery

Benefits

• Relief from pain and improved digit function
• Minimal scarring and quicker recovery compared to open surgery
• Immediate improvement might be noticed in some cases.

Recovery

• Keep the affected digit elevated and apply ice to reduce swelling.
• Over-the-counter pain medication can be used as needed.
• Follow-up appointments to monitor healing progress.
• Physical therapy might be recommended to regain strength and mobility.
• Full recovery typically within a few weeks, with gentle use of the digit allowed after a few days.

Alternatives

• Corticosteroid injections
• Physical therapy
• Splinting
• Open surgical tenotomy
• Medications or lifestyle changes, depending on the severity and specifics of the condition

Pros and Cons of Alternatives:

• Corticosteroid injections: Less invasive but may provide only temporary relief.
• Physical therapy and splinting: Non-invasive but may not be effective for severe cases.
• Open surgical tenotomy: More invasive with longer recovery but might be necessary in complex cases.

Patient Experience

• Minimal pain due to local anesthesia; slight discomfort during the procedure.
• Post-procedure might involve some soreness or tenderness, manageable with pain medication and rest.
• Convenience of a quick, outpatient procedure with rapid return to daily activities.