Name of the Procedure:

Tenotomy, extensor, hand or finger, open, each tendon
Common Name: Extensor Tendon Tenotomy

Summary

Tenotomy, extensor, hand or finger, open, is a surgical procedure where a tendon in the hand or finger is carefully cut. This procedure helps to alleviate tension or correct deformities caused by a tight or contracted tendon.

Purpose

This procedure is typically performed to:

• Relieve tension in the tendons of the hand or fingers
• Correct deformities or improve finger movement
• Alleviate pain associated with tendon tightness or contracture

Indications

The procedure is indicated for patients with:

• Tendon contractures (e.g., due to Dupuytren's contracture)
• Certain types of tenosynovitis
• Scarring or injury leading to limited finger movement
• Chronic pain not responsive to conservative treatments

Preparation

• Patients may be instructed to fast for a certain period before the procedure.
• Medications, particularly blood thinners, may need to be adjusted.
• Pre-procedure diagnostic tests may include imaging studies like X-rays or MRI, and physical examinations.

Procedure Description

1. The patient is given local anesthesia to numb the area, or general anesthesia in some cases.
2. An incision is made over the affected tendon of the hand or finger.
3. The surgeon isolates the extensor tendon and cuts it at the targeted spot.
4. The area is then cleaned, and the incision is closed with sutures.
5. A dressing is applied to protect the wound.

Tools: Scalpel, forceps, sutures, sterile dressings
Anesthesia: Local or general anesthesia, depending on the case

Duration

The procedure typically takes about 30 minutes to an hour, depending on the complexity and number of tendons involved.

Setting

This procedure is commonly performed in a hospital, outpatient surgical center, or specialized clinic.

Personnel

• Orthopedic or hand surgeon
• Surgical assistants
• Anesthesiologist or nurse anesthetist
• Operating room nurses

Risks and Complications

• Infection
• Bleeding
• Nerve damage
• Incomplete relief of symptoms
• Scarring
• Stiffness or reduced mobility in the hand or finger

Benefits

• Reduction or elimination of pain
• Improved hand or finger movement
• Correction of deformities
• Enhanced quality of life

Recovery

• Patients may need to keep the hand elevated and avoid strenuous activities.
• Pain management typically involves over-the-counter pain relievers or prescribed medications.
• Physical therapy may be recommended to enhance recovery and maintain mobility.
• Full recovery can take several weeks to a few months, depending on the individual case.
• Follow-up appointments are essential to monitor healing and address any complications.

Alternatives

• Physical therapy
• Splinting or bracing
• Corticosteroid injections
• Less invasive surgical techniques Each alternative has its pros and cons, such as lower risks but potentially less effective results compared to an open tenotomy.

Patient Experience

During the procedure, patients under local anesthesia will be awake but should not feel any pain; those under general anesthesia will be unconscious. Post-procedure, patients may experience some discomfort, swelling, and limited use of the hand, which can be managed with pain medications and proper care.