Name of the Procedure:

Lengthening of Tendon, Flexor, Hand or Finger, Each Tendon

Summary

This surgical procedure involves lengthening a flexor tendon in the hand or finger. Flexor tendons are responsible for bending the fingers and thumb. The lengthening process helps restore range of motion and function when these tendons have become too tight or shortened due to injury or a medical condition.

Purpose

The procedure addresses conditions where the flexor tendons are too tight, causing restricted movement and bent fingers. The goal is to improve hand or finger mobility and function, thus enhancing the patient's quality of life and ability to perform daily activities.

Indications

• Conditions like Dupuytren's contracture or trigger finger
• Post-injury or post-surgical scarring that causes tendon shortening
• Patients experiencing difficulty in fully opening their hand or straightening their fingers
• Cases where nonsurgical treatments like physical therapy have been ineffective

Preparation

• Patients may need to fast for 6-8 hours before the procedure if general anesthesia is used.
• Adjustments to medications may be necessary, especially for blood thinners.
• Preoperative imaging studies like X-rays or MRIs to assess the condition of the tendons and surrounding tissue.

Procedure Description

1. The patient is positioned to provide optimal access to the affected hand or finger.
2. Anesthesia is administered. This may be local, regional, or general based on the case.
3. A small incision is made over the affected tendon.
4. The surgeon carefully identifies the flexor tendon and makes precise cuts to lengthen it.
5. The tendon is then sutured in its new, lengthened position.
6. The incision is closed with stitches, and the area is bandaged.

Duration

The procedure typically takes about 1 to 2 hours, depending on the number of tendons being lengthened and the specifics of the case.

Setting

This surgery is commonly performed in a hospital or an outpatient surgical center.

Personnel

• Orthopedic Surgeon or Hand Surgeon
• Surgical Nurse
• Anesthesiologist
• Surgical Technologist

Risks and Complications

• Infection at the surgical site
• Excessive bleeding
• Allergic reaction to anesthesia
• Scar formation that may limit function
• Nerve damage
• Tendon rupture or failure to lengthen adequately

Benefits

• Improved range of motion and hand function
• Relief from pain or discomfort associated with tendon tightness
• Enhanced ability to perform daily activities
• Positive long-term outcomes with proper rehabilitation

Recovery

• Rest and elevation of the hand post-surgery
• Pain management with prescribed medications
• Wearing a splint or cast to immobilize the hand initially
• Physical therapy to regain strength and mobility
• Gradual return to normal activities over 8-12 weeks
• Follow-up appointments to monitor healing

Alternatives

• Non-surgical approaches like physical therapy, splinting, or corticosteroid injections
• Pros: Less invasive, no surgical risks
• Cons: May not be as effective for severe cases

Patient Experience

During the procedure, the patient will be under anesthesia and should feel no pain. Post-surgery, there may be discomfort and swelling, which can be managed with medications and ice. Physical therapy plays a crucial role in regaining function, and patients should follow their therapist's instructions for the best outcomes. Recovery typically includes a gradual return to normal activities and follows up with the healthcare team to ensure proper healing.