A Post-Operative Regime after Digital Flexor Tenolysis

Abstract

Tenolysis of the flexor tendons was performed in 78 fingers (72 patients) by the same surgeon. Two technical modifications were introduced: reconstruction of a robust pulley; and initial immobilization with the tendon in a proximally migrated position, permitting later breakdown of early adhesions by gentle extension either by the surgeon or using an extension spring. After a mean follow-up of 21.5 months, the total active movement was improved from 135° (pre-operative) to 203° (post-operative) in 84% of fingers and from 65° to 115° in 78% of thumbs. This corresponds to a reduction in impairment of 10.1% for the thumb and 21.6% for the fingers. There was no improvement in four digits and nine cases were made worse, averaging a loss of range of 25.4°. Among these were two cases of skin breakdown and two cases of tendon rupture (2.5%), one combined with skin necrosis.