Tendons are strong, flexible bands of connective tissue connecting muscles to bones. They facilitate movement by transmitting muscle contractions to the skeletal system. Tendon release surgery is a medical procedure designed to restore normal movement and alleviate discomfort by addressing overly tight or restricted tendons.
Understanding Tendon Release Surgery
Tendon release surgery involves cutting or lengthening a constricted tendon to relieve tension and improve joint mobility. This reduces the pulling force of a tight tendon that restricts movement, causes pain, or deforms a joint. By altering the tendon’s length, the surgeon aims to re-establish balanced tension around the affected joint.
When a tendon is too short or stiff, it can pull a joint into an abnormal position or limit its range of motion. Releasing the tendon allows the associated muscle to relax, enabling the joint to move more freely. This procedure can improve function and reduce discomfort from tendon contractures.
Common Conditions Treated
Tendon release surgery is a common treatment for several conditions where tendon tightness impedes normal function. One condition is trigger finger, where inflammation narrows the tendon sheath in the finger, causing it to catch or lock. Releasing the sheath allows the tendon to glide smoothly, alleviating the catching sensation.
Clubfoot, a congenital deformity where the foot is turned inward, often involves tight tendons. An Achilles tendon release lengthens the heel cord, allowing the foot to be positioned more normally. For individuals with cerebral palsy, spasticity can cause muscle and tendon contractures that restrict movement. Tendon release surgeries, like hamstring or Achilles tendon lengthening, can improve joint range of motion and functional independence.
Carpal tunnel syndrome, involving median nerve compression in the wrist, can benefit from tendon sheath release. Hand deformities from injury or congenital conditions may also require tendon release to restore function and alignment. In all these conditions, excessive tendon tension is the main cause of symptoms and functional limitations.
The Surgical Process
Tendon release surgery begins with anesthesia, which can be local, regional, or general. The choice depends on the specific tendon, procedure complexity, and patient health. Once anesthesia is effective, the surgeon makes a small incision over the affected tendon.
Through this incision, the surgeon accesses the constricted tendon. The release involves either a precise cut (tenotomy) to sever the tendon, allowing it to retract and lengthen, or a lengthening procedure (tendon lengthening). In lengthening, the tendon is cut partially and allowed to stretch, or cut in a Z-shape and re-sutured in an elongated position. The technique used depends on the tightness and desired outcome. After the tendon is released, the incision is closed with sutures or surgical tape and dressed.
Life After Tendon Release Surgery
Following tendon release surgery, post-operative care focuses on pain management and protecting the surgical site. Pain medication is prescribed for comfort. The incision is covered with bandages, and a splint or cast may be applied to immobilize and protect the healing tendon.
Rehabilitation is a key part of recovery, often beginning days or weeks after surgery. Physical or occupational therapy sessions are prescribed to regain strength, flexibility, and function. These sessions involve exercises to increase range of motion, strengthen surrounding muscles, and improve coordination. The therapist also guides on activities to avoid during healing.
The recovery timeline varies depending on the individual, the specific tendon, and the extent of the release. Minor releases, like for trigger finger, might improve within weeks, while more extensive procedures, such as for clubfoot or cerebral palsy, can require several months of rehabilitation. Following all post-operative instructions, including wound care, medication adherence, and consistent therapy, is important for achieving the optimal outcome. The goal is to improve mobility, alleviate pain, and restore the affected area’s function.