Flexor tenolysis

Abstract

Tenolysis is a well-established salvage procedure, which can be applied when non-gliding adhesions form along the surface of a tendon after injury or repair and prevent gliding of the tendon in the performance of its intended function.(8,15,17,29,30,39,40,44,49) Tendon adhesions will occur whenever the surface of a tendon is damaged either through the injury itself, be it laceration or crush, or by surgical manipulation.(18) At any point on the surface of a tendon where violation occurs, an adhesion will form in the healing period.(20,26) When these adhesions cannot be mobilised by an adequate course of hand therapy, tenolysis should be considered. This procedure is as difficult or more so than tendon repair itself and should not be undertaken lightly. It represents another surgical incursion into an area of previous trauma and surgery. If the procedure is not successful, the patient's hand may show no improvement or even be worse. The risk of further decreasing the circulatory supply and innervation to an already deprived finger is a real one. Rupture of the lysed tendon, a disastrous complication, is the major hazard of tenolysis.