Name of the Procedure:

Tenotomy, open, extensor, foot or toe, each tendon

Summary

An open tenotomy is a surgical procedure in which a surgeon makes an incision to cut a tendon in the foot or toe. This helps relieve tension and correct deformities caused by tight or shortened tendons.

Purpose

The procedure addresses conditions such as hammertoes or claw toes, which are deformities caused by the shortening of extensor tendons in the foot or toe. The goal is to reduce pain, improve mobility, and correct the deformity for better function and appearance.

Indications

• Persistent pain in the foot or toe due to tendon contracture
• Deformities like hammertoes or claw toes
• Difficulty in fitting shoes due to toe deformities
• Failed conservative treatments such as orthotics or physical therapy

Preparation

• Fasting for 8-12 hours before the procedure if general anesthesia is used
• Adjustment of current medications as advised by the healthcare provider
• Preoperative assessments including blood tests, X-rays, or MRI

Procedure Description

1. The patient is placed under local, regional, or general anesthesia.
2. A small incision is made over the affected tendon.
3. The surgeon identifies and cuts the tendon to release tension.
4. The incision is then closed with stitches, and a dressing is applied. Tools used include a scalpel, forceps, scissors, and suturing materials.

Duration

The procedure typically takes about 30 to 60 minutes.

Setting

The procedure is performed in a hospital surgical suite or an outpatient surgical center.

Personnel

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

Risks and Complications

• Infection at the incision site
• Bleeding or hematoma
• Nerve damage leading to numbness or weakness
• Recurrence of the deformity
• Poor wound healing or scarring
• Blood clot formation

Benefits

• Relief from pain caused by tendon tension
• Correction of toe deformity
• Improved function and mobility of the foot or toe
• Enhanced ability to wear normal footwear comfortably Benefits are usually noticed within weeks to a few months post-surgery.

Recovery

• Keeping the foot elevated for the first few days post-procedure
• Pain management with prescribed medications
• Limited weight-bearing on the affected foot, use of crutches or a protective boot as advised
• Follow-up appointments to monitor healing and remove stitches
• Physical therapy may be recommended to improve strength and flexibility Full recovery typically takes 4 to 6 weeks.

Alternatives

• Non-surgical options like physical therapy, orthotic devices, or splints
• Other surgical procedures such as tendon lengthening or arthroplasty Non-surgical treatments are less invasive but may provide limited relief; surgical alternatives vary based on the specific condition and severity.

Patient Experience

During the procedure, the patient should feel minimal discomfort due to anesthesia. Post-surgery, some pain, swelling, and bruising are expected. Pain is generally manageable with medications, and mobility gradually returns with proper care and rehabilitation steps.