Name of the Procedure:

Tenolysis, flexor or extensor tendon, leg and/or ankle; single, each tendon

Summary

Tenolysis is a surgical procedure performed to release a tendon that has become adhered to surrounding tissues, thereby limiting its movement. This procedure aims to restore proper tendon function, enabling normal motion of the leg or ankle.

Purpose

Tenolysis addresses issues where tendons in the leg or ankle become stuck or scarred down within their sheath. The goal is to improve mobility, reduce pain, and restore functional use of the affected extremity.

Indications

• Limited range of motion in the leg or ankle due to tendon adhesions.
• Pain associated with tendon restriction.
• Previous surgeries or traumatic injuries leading to scarring around tendons.
• Failed conservative treatments like physical therapy.

Preparation

• Patients may be instructed to fast for a certain period before the procedure.
• Medication adjustments may be necessary, particularly blood thinners.
• Pre-operative tests could include imaging studies like MRI or ultrasound and blood tests.

Procedure Description

1. Anesthesia: Typically performed under local or regional anesthesia with sedation.
2. Incision: A small incision is made over the affected tendon.
3. Isolation: The surgeon will carefully separate the scarred tendon from surrounding tissues.
4. Release: The adhesions are meticulously cut away to free the tendon.
5. Closing: The incision is closed with sutures, and the site is bandaged.

Tools used include scalpels, scissors, and possibly microsurgical instruments to precisely remove adhesions.

Duration

The procedure usually takes about 60 to 90 minutes per tendon, depending on the complexity of the adhesions.

Setting

Tenolysis is typically performed in a hospital or outpatient surgical center.

Personnel

• Orthopedic or specialized surgeon
• Surgical nurse
• Anesthesiologist or nurse anesthetist

Risks and Complications

Common risks:

• Infection
• Bleeding
• Swelling

Rare complications:

• Nerve damage
• Re-adhesion of the tendon
• Prolonged pain or stiffness

Benefits

• Improved range of motion
• Decreased pain
• Enhanced functional use of the leg or ankle Benefits may begin to show within weeks, with full recovery taking several months.

Recovery

• Immediate post-procedure care involves rest, ice, compression, and elevation (RICE).
• Patients may need to wear a splint or boot initially.
• Physical therapy is usually required to regain strength and flexibility.
• Recovery time can range from a few weeks to several months.

Alternatives

• Nonsurgical treatments like physical therapy, NSAIDs, or corticosteroid injections.
• Other surgical options, depending on the cause and extent of the adhesion.

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The doctor will help weigh the pros and cons of alternatives to determine the best treatment plan.

Patient Experience

• During the procedure, discomfort should be minimal due to anesthesia.
• Post-surgery, patients may experience pain and swelling, which can be managed with medications.
• Physical therapy involves exercises to regain motion, which could be uncomfortable initially but is essential for recovery.