Name of the Procedure:

Tenotomy, Flexor, Finger, Open, Each Tendon

Summary

A tenotomy is a surgical procedure that involves cutting a tendon to relieve tension. For the flexor tendons in the finger, this procedure helps to correct issues like stiffness or contractures that limit finger movement. The surgery is performed through an open approach, meaning an incision is made to expose the tendon.

Purpose

This procedure addresses conditions such as tendon contractures, Dupuytren's contracture, or severe tendonitis that restricts finger movement. The primary goal is to improve the range of motion and reduce pain or discomfort caused by the tightened tendon.

Indications

• Persistent finger stiffness or contracture
• Dupuytren's contracture
• Severe, unresponsive flexor tendonitis
• Functional impairment due to tendon tension

Preparation

• Fasting for several hours before surgery, typically overnight
• Discontinuing certain medications like blood thinners as advised
• Preoperative diagnostic tests, such as X-rays or MRI, may be required to assess the extent of the tendon issue

Procedure Description

1. The patient is given local or general anesthesia depending on the case.
2. An incision is made in the skin overlying the affected tendon.
3. The surgeon carefully cuts (releases) the tendon to allow it to lengthen or relax.
4. The incision is then closed with sutures.
5. A bandage or splint may be applied to the finger to immobilize it temporarily.

Duration

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

Setting

The tenotomy is usually performed in a hospital, outpatient clinic, or surgical center.

Personnel

• Orthopedic or hand surgeon
• Surgical nurses
• Anesthesiologist or nurse anesthetist

Risks and Complications

• Infection at the incision site
• Excessive bleeding
• Damage to surrounding nerves or tissues
• Incomplete relief of symptoms
• Scar tissue formation
• Adverse reactions to anesthesia

Benefits

• Improved finger mobility and function
• Relief from pain and discomfort
• Increased ability to perform daily activities

Recovery

• Post-procedure care involves wound care and possibly physio/occupational therapy.
• Pain medication may be prescribed to manage discomfort.
• Recovery time can vary but typically ranges from several weeks to a few months.
• Patients may be advised to avoid strenuous activities until fully healed.
• Follow-up appointments are necessary to monitor healing and progress.

Alternatives

• Non-surgical treatments like physical therapy, splinting, or corticosteroid injections
• Minimally invasive procedures, such as needle aponeurotomy for Dupuytren’s contracture
• The pros of non-surgical options include lower risk and quicker recovery, but they may not be as effective in severe cases.

Patient Experience

• During the procedure, if local anesthesia is used, the patient will remain awake but should not feel pain.
• After the procedure, there may be some swelling, bruising, and discomfort, which can be managed with pain relievers.
• Full recovery can take several weeks to months, during which time hand therapy may be recommended to restore function fully.