Name of the Procedure:

Tenolysis, flexor tendon; palm AND finger, each tendon Common names: Tendon Release Surgery, Flexor Tendon Release

Summary

Tenolysis is a surgical procedure aimed at freeing a tendon from adhesions, which are scar tissues that bind the tendon, preventing it from moving freely. This specific procedure focuses on the flexor tendons located in the palm and fingers.

Purpose

The procedure is intended to restore normal movement and function to fingers that may be stiff or have limited range of motion due to tendon adhesions. The main goal is to reduce pain, improve finger dexterity, and return the hand to its normal functionality.

Indications

• Limited range of motion in the fingers
• Pain during finger movement
• Stiffness and inability to properly flex the fingers
• Patients with previous tendon injuries or surgeries followed by inadequate healing

Preparation

• Patients may be required to fast before the procedure, especially if general anesthesia is used.
• Adjustments to medication, particularly blood thinners, may be necessary.
• Preoperative assessments like blood tests and imaging studies (X-rays, MRIs) are conducted to evaluate the severity of tendon adhesions.

Procedure Description

1. The patient is administered anesthesia – local, regional, or general based on the case.
2. An incision is made in the palm and/or fingers to expose the affected flexor tendons.
3. Scar tissue (adhesions) surrounding the tendons is carefully removed.
4. The surgeon ensures the tendon can move freely within its sheath.
5. The incision is closed with sutures, and the hand is bandaged.
6. A splint may be applied to immobilize the hand during initial healing.

Duration

The procedure typically takes about 1 to 2 hours, depending on the extent of adhesions and number of tendons involved.

Setting

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

Personnel

• Orthopedic surgeon or hand surgeon
• Anesthesiologist or nurse anesthetist
• Surgical nurses and operating room technicians

Risks and Complications

• Infection
• Bleeding
• Nerve injury
• Recurrence of adhesions
• Stiffness or reduced range of motion
• Pain or discomfort during recovery

Benefits

• Improved range of motion and flexibility in the fingers
• Reduction or elimination of pain
• Enhanced ability to perform daily activities and tasks
• Benefits are typically observable within weeks to a few months post-surgery, depending on rehabilitation.

Recovery

• Follow post-procedure care instructions, including keeping the hand elevated.
• Pain management may involve prescribed medications.
• Physical therapy is essential for restoring function and strength.
• Recovery time varies but typically spans 6-8 weeks before returning to normal activities.
• Follow-up appointments to monitor healing and progress.

Alternatives

• Physical therapy and occupational therapy
• Anti-inflammatory medications
• Corticosteroid injections
• Splinting or bracing These alternatives may be less invasive but might not provide long-term relief if significant adhesions are present.

Patient Experience

• Patients may experience some pain and swelling post-surgery, managed by pain medications.
• Discomfort during initial physical therapy is common but necessary for optimal recovery.
• Full return to activities may take several weeks, during which gradual improvement in hand function and flexibility is anticipated.

Pain management and strict adherence to rehabilitation protocols are crucial for a successful outcome.