Tenotomy surgery is a medical procedure designed to address issues with tendons, which are the fibrous tissues connecting muscles to bones. This surgical intervention involves either cutting or lengthening a specific tendon to relieve tension or correct a deformity. It serves as a method to improve mobility and function in individuals experiencing restricted movement due to shortened or tight tendons.
What is Tenotomy?
Tenotomy is a surgical procedure that involves precisely cutting or lengthening tendons. Its objective is to release abnormal tension, rectify physical deformities, or enhance the range of motion within affected joints. This procedure addresses situations where a tendon has become shortened or contracted, pulling a joint into an unnatural position or severely limiting its movement. By carefully altering the tendon’s length, surgeons can alleviate the constant pull, allowing the associated muscle to relax and the joint to achieve a more natural alignment or greater flexibility. This helps restore functional movement.
Why a Tenotomy May Be Needed
Tenotomy is often considered when tendons become pathologically tight or shortened, leading to restricted joint movement and functional limitations. A common condition addressed is clubfoot, also known as congenital talipes equinovarus, where the foot is twisted inward and downward from birth due to shortened tendons. Lengthening these tendons allows the foot to be positioned correctly.
Individuals with cerebral palsy may also benefit from tenotomy to manage spasticity, a condition characterized by stiff or tight muscles and exaggerated reflexes. The procedure can release tight tendons in the limbs, reducing muscle contractures and improving overall limb positioning and function. Similarly, torticollis, or “wry neck,” caused by a tight sternocleidomastoid muscle in the neck, can be treated with tenotomy to restore a normal head position and range of motion. When conservative treatments like physical therapy and bracing are not sufficient, tenotomy offers a surgical option to alleviate pain and improve mobility.
How a Tenotomy is Performed
Tenotomy can be performed through different approaches, depending on the specific tendon and the extent of the condition. Open surgery involves a larger incision to directly access and visualize the tendon. Alternatively, a percutaneous approach uses a very small puncture in the skin, allowing for a less invasive intervention.
Prior to the procedure, the patient receives anesthesia, which can range from local, numbing only the surgical area, to regional, blocking sensation in a larger body part, or general, inducing a state of unconsciousness. Once the patient is appropriately anesthetized, the surgeon makes the incision or puncture. Using specialized instruments, the targeted tendon is then precisely cut or lengthened to achieve the desired release of tension and correction of the deformity.
What to Expect After Tenotomy
Following tenotomy, immediate post-operative care focuses on managing discomfort and stabilizing the corrected position. Patients typically experience some pain, controlled with prescribed medications. To maintain the lengthened or released tendon in its new position, a cast, splint, or brace is commonly applied to the affected limb or joint.
Physical therapy and rehabilitation are important components of the recovery process. These sessions begin soon after surgery, focusing on gentle exercises to regain strength, improve flexibility, and restore the full range of motion. While rare, potential complications include infection at the surgical site, temporary nerve irritation, or a recurrence of the original deformity if proper post-operative care and therapy are not followed. The overall long-term outlook for tenotomy is generally favorable, with the goal being improved function, reduced pain, and enhanced mobility.