One hundred and thirty-four patients, who had 163 operations resulting in 220 flexor and extensor tenolyses of the hand and wrist at the Derbyshire Royal Infirmary from the years 1944 through 1964, have been reviewed. The indications and the conditions which should be satisfied before tenolysis is performed are described as well as the results and operative technique. While tenolysis was not a totally satisfactory procedure in all cases, varying degrees of improvement were obtained in 114 patients (85 per cent); seventy-six patients (57 per cent) showed moderate to considerable (sometimes normal functional) improvement, and thirty-eight patients (28 per cent) had slight improvement as a result of tenolysis. Eleven patients (8 per cent) showed no change; nine patients (7 per cent) were either worse or had tendon ruptures following tenolysis.
Cortisone was given to thirty-one patients in conjunction with tenolysis. No appreciable beneficial effect on the final results was noted. When improvement occurs, it is often dramatic and, if present at three to four weeks after operation, it is usually maintained.
Tenolysis is a useful procedure to improve function of tendons bound down in scar tissue when the indications and techniques are carefully followed. Tenolysis is unsuccessful when done in the face of poor indications, when the tendon is not freed completely, or when the tenolysis is performed in association with complex orthopaedic procedures which do not permit early postoperative active motion.
Copyright 1967 by The Journal of Bone and Joint Surgery, Incorporated