Name of the Procedure:

Tenolysis, Flexor, Foot; Single Tendon

Summary

Tenolysis is a surgical procedure aimed at removing adhesions (scar tissue) around a tendon to restore its normal movement. This specific procedure targets a single flexor tendon in the foot.

Purpose

The procedure addresses restricted tendon movement caused by scar tissue formation, which can result in pain, stiffness, and impaired function. The goal is to free the tendon, allowing it to glide smoothly again and improve overall foot function.

Indications

Patients who have:

• Limited range of motion in the foot due to tendon adhesions
• Pain during foot or toe movement
• History of trauma or surgery that led to scar tissue formation around the tendon
• Failed conservative treatments like physical therapy

Preparation

• Patients may need to fast for a certain period before the procedure.
• Medication adjustments might be required, particularly if the patient is on blood thinners.
• Pre-operative assessments may include imaging studies like an MRI or ultrasound to evaluate the tendon and surrounding tissues.

Procedure Description

1. Anesthesia: The patient may receive local anesthesia with sedation or general anesthesia.
2. Incision: A small incision is made over the affected tendon.
3. Release Adhesions: Using specialized surgical instruments, the surgeon carefully removes the scar tissue around the tendon.
4. Closure: The incision is then closed with sutures or surgical staples, and a sterile dressing is applied.

Duration

The procedure typically takes between 30 minutes to 1 hour.

Setting

Tenolysis is usually performed in an outpatient surgical center or hospital.

Personnel

• Orthopedic or podiatric surgeon
• Surgical nurse
• Anesthesiologist or nurse anesthetist
• Operating room technician

Risks and Complications

• Infection
• Bleeding
• Nerve damage
• Failure to fully relieve symptoms
• Recurrence of adhesions

Benefits

• Improved tendon movement
• Reduced pain
• Enhanced foot function
• Increased ability to perform daily activities and exercises

Recovery

• Patients can typically go home the same day.
• Pain management may include prescribed medications.
• Elevation and limited weight-bearing on the affected foot are usually recommended initially.
• Physical therapy may be necessary to regain strength and mobility.
• Full recovery usually takes several weeks to a few months, depending on the individual's healing process.

Alternatives

• Non-surgical options like physical therapy, splinting, and anti-inflammatory medications.
• Tendon transfer or more extensive reconstructive surgery for severe cases.
• Each alternative comes with its own set of pros and cons regarding effectiveness, recovery time, and potential risks.

Patient Experience

• During the procedure, patients under local anesthesia may feel pressure but should not feel pain.
• Post-procedure, common sensations include mild to moderate pain and swelling, which are managed with medications and rest.
• Comfort measures like ice packs and elevation can help alleviate discomfort during recovery.