Tenolysis of Stiff Fingers: Outcome Analysis of Our Technique

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Author(s): 1,5Shalamar Medical College, Lahore; 2Christine Kleinert institute, Taiwan; 3Schenectady, New York, United States; 4Karolinska institute Sweden

Revised: 06/01/2024 | Pages: 16-19 | DOI: https://doi.org/10.5455/pjps.249-1686290393


Background: Hand trauma invariably leads to stiffness and reduced range of motion which may be attributed to adhesions and fibrosis. Flexor tenolysis involves resection of all adhesive tissue around the tendon inside and outside the tendon sheath. Many methods have been described in the literature for tenolysis, and all have their pros and cons.
Objective: This study seeks to present findings from employing our approach to treat stiff fingers, which involves tenolysis of both flexor and extensor tendons in patients under local anesthesia whereby patients can actively move their digits to facilitate complete release.
Methodology: A retrospective analysis was done of the charts of all the patients who underwent tenolysis with this method during the 4-year study period. All demographic and clinical data was recorded, including the initial trauma mechanism. The pre-operative and post-operative total active motion (TAM), and flexion lag, were noted and compared. Any complications were also documented.
Results: 34 hands (in 30 patients) were operated upon in the given period. Average age was 41 years. 19 patients were males, 11 were females. Average pre-operative TAM was 102o and average post-operative TAM was 2100. This result was statistically significant (p<0.05). There were no surgical complications seen.
Conclusion: complete removal of all adhesions around the flexor and extensor tendons greatly improves the active range of motion of involved digits. Moreover, performing the procedure under local anesthesia allows thepatient to vigorouslymovetheirfingersper-operatively, whichfacilitatesacompleteandeffective release.
Keywords | finger stiffness, tenolysis, hand trauma, total active motion