Name of the Procedure:

Tenolysis, extensor tendon, hand OR finger, each tendon

Summary

Tenolysis is a surgical procedure to release and free up an extensor tendon in the hand or fingers from adhesions or scar tissue that are restricting its movement. This helps improve the tendon’s ability to glide smoothly, reducing stiffness and improving function.

Purpose

This procedure is designed to address conditions where an extensor tendon in the hand or fingers is unable to move freely due to adhesions or scar tissue. The goal is to restore normal tendon movement, alleviate pain, and improve the range of motion and function in the affected hand or fingers.

Indications

• Limited range of motion in the hand or finger due to tendon adhesions or scarring.
• Persistent stiffness or inability to extend the finger despite conservative treatments.
• Pain or discomfort during finger or hand movement.

Preparation

• The patient may be instructed to fast for a specified period before the surgery.
• Adjustments to medications (e.g., blood thinners) may be necessary.
• Preoperative tests such as blood work or imaging studies might be conducted.
• The patient and surgeon will discuss anesthesia options and procedure details.

Procedure Description

1. The patient is typically given regional or local anesthesia to numb the area.
2. An incision is made over the affected tendon in the hand or finger.
3. The surgeon carefully identifies and cuts away the adhesions or scar tissue surrounding the tendon.
4. The tendon is tested for free movement before the incision is closed with sutures.
5. The surgical site is bandaged and a splint or brace may be applied to protect the area during initial healing.

Duration

The procedure usually takes about 30 to 90 minutes, depending on the extent of the adhesions and the number of tendons involved.

Setting

Tenolysis is typically performed in a hospital, outpatient surgical center, or specialized hand surgery clinic.

Personnel

The procedure is conducted by a specialized hand surgeon, with the support of surgical nurses and an anesthesiologist or nurse anesthetist.

Risks and Complications

• Infection at the surgical site.
• Bleeding or hematoma.
• Nerve damage leading to numbness or weakness.
• Recurrence of adhesions or continued stiffness.
• Pain or swelling in the hand or fingers.

Benefits

• Improvement in the range of motion and hand function.
• Alleviation of pain associated with tendon restrictions.
• Enhanced ability to perform daily activities.

Recovery

• Patients will receive detailed post-procedure care instructions, including wound care and medications to manage pain and swelling.
• Hand therapy may be recommended to aid recovery and restore function.
• Most patients can resume light activities within a few weeks, but full recovery may take several months.
• Follow-up appointments will be scheduled to monitor progress.

Alternatives

• Non-surgical treatments like physical therapy, splinting, or anti-inflammatory medications.
• Corticosteroid injections to reduce inflammation.
• Wearing a different type of splint or brace to manage symptoms.
• Each alternative has its own risks and benefits, usually providing temporary relief compared to the longer-term solution offered by surgery.

Patient Experience

During the procedure, the patient will be under anesthesia and should not feel pain. Post-surgery, there could be discomfort, swelling, or bruising which can be managed with prescribed pain medications and proper wound care. Physical therapy will help regain strength and movement, and adhering to recovery guidelines will contribute to a successful outcome.