Name of the Procedure:

Tenolysis, Extensor, Foot; Multiple Tendons

Summary

Tenolysis is a surgical procedure that involves freeing a tendon from surrounding adhesions to improve its movement. This specific type involves the extensor tendons in the foot. It helps restore function and alleviate pain.

Purpose

The procedure addresses difficulties with tendon movement due to scarring or adhesions. The goal is to restore the normal gliding motion of the tendons, reducing pain, improving foot function, and allowing for easier movement.

Indications

• Persistent foot pain due to tendon adhesions
• Reduced mobility of the toes or foot
• Failure to improve with conservative treatments like physical therapy
• Diagnostic imaging showing clear tendon adhesions

Preparation

• Fasting for 8-12 hours before surgery
• Adjustments to medications, particularly blood thinners
• Preoperative imaging studies (like MRI or ultrasound) to assess the extent of adhesions
• Preoperative physical evaluation and clearance

Procedure Description

1. The patient is positioned and the foot is sterilized.
2. Anesthesia is administered (typically regional or general).
3. An incision is made over the affected area.
4. The surgeon carefully isolates the extensor tendons.
5. Using specialized instruments, the surgeon releases the adhesions surrounding the tendons.
6. The incision is closed with sutures.
7. A sterile dressing is applied to the surgical site.

Duration

The procedure typically takes about 1 to 2 hours, depending on the extent of the adhesions.

Setting

The procedure is usually performed in a hospital operating room or a specialized surgical center.

Personnel

• Orthopedic Surgeon or Podiatric Surgeon
• Surgical Nurse
• Anesthesiologist
• Operating Room Technician

Risks and Complications

• Infection
• Excessive bleeding
• Nerve damage
• Recurrence of adhesions
• Delayed healing
• Adverse reactions to anesthesia

Benefits

• Improved range of motion
• Reduction or elimination of pain
• Enhanced functional use of the foot
• Faster return to normal activities

Recovery

• Foot elevation and rest for the first few days
• Pain management with prescribed medications
• Icing the affected area to reduce swelling
• Physical therapy to regain strength and mobility
• Follow-up appointments to monitor healing
• Generally, full recovery can take several weeks to a few months

Alternatives

• Physical therapy to manage symptoms conservatively
• Corticosteroid injections to reduce inflammation
• Tendon gliding exercises
• Pros of alternatives: Less invasive
• Cons of alternatives: May not address severe adhesions effectively

Patient Experience

During the procedure, the patient will either be asleep or given regional anesthesia to numb the area. Postoperatively, they might experience some pain and swelling, which is manageable with medications. They will be advised to keep the foot elevated and avoid putting weight on it initially. Physical therapy will aid in regaining function, and most patients can expect significant improvement over time.