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Tenolysis

(Tendolysis)

Pronounced: teah-NAH-lah-sys

Definition

Tenolysis is surgery to release a tendon affected by adhesions. A tendon is a type of tissue that connects muscle to bone. An adhesion happens when scar tissue forms and binds tendons to surrounding tissue. This can make it difficult for the affected body part to work correctly. For example, adhesion in the fingers can cause the tendons to become stuck. This prevents the fingers from being able to move properly.

This surgery is often done on hands and wrists.

Tendons in Finger

Finger Tendon
Copyright © Nucleus Medical Media, Inc.

Reasons for Procedure    TOP

You may have tendon adhesions if you had an injury to the area or if you had surgery that affected the tendon. Tenolysis is done when other therapies, like physical therapy, are unsuccessful.

In addition to tenolysis, other procedures may need to be done. The goal is to have full movement of the affected body part.

Possible Complications    TOP

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:

  • Damage to nerves or other nearby structures
  • Inability to have full movement of the affected body part
  • Pain and stiffness
  • Infection
  • Ruptured tendon
  • Amputation

Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as:

  • Smoking
  • Excessive alcohol use
  • Chronic disease such as diabetes or obesity

What to Expect    TOP

Prior to Procedure

Your doctor may do the following:

  • Physical exam
  • Blood and urine tests
  • MRI to see images of the affected tendon

Talk to your doctor about any medications, herbs, or supplements you are taking. You may be asked to stop taking some medications up to one week before the procedure, like:

  • Anti-inflammatory medications such as ibuprofen and naproxen
  • Blood thinners
  • Anti-platelet medications

Do not eat or drink anything after midnight the day before your surgery, unless told otherwise by your doctor.

Anesthesia

Anesthesia will keep you pain-free and comfortable during the procedure. Anesthesia methods include:

Description of the Procedure    TOP

A tourniquet will be tied near the area where the surgery will occur. This will prevent blood flow to that area. An incision will be made in the skin to expose the tendon and surrounding tissue. The tissue will be cut to release the tendon. During surgery, your ability to move the affected body part will be checked. Based on the movement, the doctor can assess if the procedure is working or if additional procedures need to be done. This may include reconstructing the tendon. The incision will be closed with stitches.

How Long Will It Take?    TOP

This depends on which tendon is affected and how bad the adhesions are. For example, if you injured the flexor tendon in your finger, it can take 45-60 minutes to repair.

How Much Will It Hurt?    TOP

Anesthesia will block pain during the procedure. You will have pain after the procedure. Ask your doctor about medication to help manage pain.

Average Hospital Stay    TOP

This procedure is done in a hospital setting. The usual length of stay is 1-2 days. If you have any problems, you will need to stay longer.

Post-procedure Care    TOP

At the Hospital

Right after the procedure, you will be taken to recovery and monitored closely. The staff may give you:

  • Pain medication
  • Antibiotics to prevent infection
  • Medication to prevent blood clots

During your stay, the hospital staff will take steps to reduce your chance of infection such as:

  • Washing their hands
  • Wearing gloves or masks
  • Keeping your incisions covered

There are also steps you can take to reduce your chances of infection such as:

  • Washing your hands often and reminding visitors and healthcare providers to do the same
  • Reminding your healthcare providers to wear gloves or masks
  • Not allowing others to touch your incisions
At Home

When you return home, do the following to help ensure a smooth recovery:

  • Your stitches will be removed about 2 weeks after surgery. You will be able to return to light activities once your stitches are removed. Avoid strenuous activities for at least four weeks.
  • Do not lift anything heavy until your doctor says it is okay to do so.

Call Your Doctor    TOP

Call your doctor if any of the following occurs:

  • Pain that you cannot control with the medications you have been given
  • Signs of infection, such as fever or chills
  • Swelling, redness, or pain from the incision site
  • Numbness or tingling
  • New or worsening symptoms

If you think you have an emergency, call for medical help right away.

RESOURCES:

American Academy of Orthopaedic Surgeons
http://orthoinfo.org
American Society for Surgery of the Hand
http://assh.org

CANADIAN RESOURCES:

The Canadian Orthopaedic Association
http://coa-aco.org
Canadian Orthopaedic Foundation
http://canorth.org

References:

Feldscher SB, Schneider LH. Flexor tenolysis. Hand Surg. 2002;7(1):61-74.
Overview of hand surgery. Johns Hopkins Medicine website. Available at:
...(Click grey area to select URL)
Accessed February 26, 2014.
Replantation. American Academy of Orthopaedic Surgeons Ortho Info website. Available at:
...(Click grey area to select URL)
Updated December 2013. Accessed February 26, 2014.
6/6/2011 DynaMed's Systematic Literature Surveillance
...(Click grey area to select URL)
Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.e8.
Last reviewed February 2014 by Michael Woods, MD
Last Updated: 2/26/2014