Our Summary

Flexor tendon injuries in the hand can cause significant problems. Sometimes, during the healing process, the tendon and surrounding area can form adhesions, which are sticky tissues that can limit the hand’s movement. Tenolysis is a surgical procedure to remove these adhesions.

This paper reviews research on the outcomes of this surgery. The authors looked at studies that were in English, involved patients who had tenolysis, and reported on how well the hand could move after surgery. They found five articles that fit these criteria.

Most of the patients were male, and the average age was about 37 years old. On average, it took about 15 months from the time of the initial injury to the surgery. The follow-up period after surgery was, on average, 18.6 months.

The results were generally positive. According to four of the studies, about 79% of patients had excellent or good results. The fifth study reported 80% of patients had excellent or good outcomes. However, there were some complications, with about 15% of patients experiencing problems after surgery.

The authors concluded that tenolysis can significantly improve the movement of the hand. However, it’s important to weigh these benefits against the potential complications. Therefore, a thorough conversation with the patient should happen before deciding on this surgery.

FAQs

  1. What is tenolysis and why is it performed?
  2. What were the general outcomes of tenolysis according to the studies reviewed in the paper?
  3. What complications were reported in the studies about tenolysis surgery?

Doctor’s Tip

The doctor might advise the patient that tenolysis surgery can greatly improve hand movement but also comes with potential complications. It is important to have a thorough discussion with the doctor before deciding on this surgery to weigh the benefits and risks. It is also important to follow post-operative care instructions carefully to ensure the best possible outcome.

Suitable For

Patients who are typically recommended hand surgery include those with flexor tendon injuries that have resulted in limited hand movement due to the formation of adhesions. These patients may experience difficulty with activities of daily living and may benefit from tenolysis to improve hand function. It is important to consider the potential benefits and risks of surgery and have a thorough discussion with the patient before proceeding with the procedure.

Timeline

Before hand surgery:

  • Patient experiences a flexor tendon injury in the hand
  • Tendon and surrounding area may form adhesions, limiting hand movement
  • Patient undergoes evaluation by a hand surgeon
  • Decision is made to proceed with tenolysis surgery
  • Pre-operative preparation and planning

After hand surgery:

  • Surgery is performed to remove adhesions and improve hand movement
  • Post-operative recovery period, which may involve physical therapy
  • Follow-up appointments with the hand surgeon to monitor progress
  • Evaluation of outcomes, including hand movement and function
  • Potential complications and management of any issues that arise
  • Continued rehabilitation to optimize hand function and prevent future injuries

What to Ask Your Doctor

Some questions a patient should ask their doctor about hand surgery for flexor tendon injuries and tenolysis include:

  1. What are the potential benefits of tenolysis surgery for my hand injury?
  2. What are the potential risks and complications associated with tenolysis surgery?
  3. How long is the recovery process after tenolysis surgery?
  4. What type of rehabilitation or physical therapy will be needed after the surgery?
  5. What are the success rates of tenolysis surgery in improving hand movement?
  6. Are there any alternative treatments or therapies that I should consider before opting for surgery?
  7. How experienced are you in performing tenolysis surgery and what is your success rate?
  8. What can I expect in terms of pain management after the surgery?
  9. Will I need to take time off work or make any lifestyle changes during the recovery period?
  10. Are there any specific precautions I should take to prevent re-injury after the surgery?

Reference

Authors: Kher S, Graham DJ, Symes M, Lawson R, Sivakumar BS. Journal: J Hand Surg Asian Pac Vol. 2021 Dec;26(4):580-587. doi: 10.1142/S2424835521500557. PMID: 34789105