Feasibility of Ultrasound-Guided Hydrodissection for Tenolysis of Adhesions Following Digital Flexor Tendon Repair

Flexor tendon adhesions are common after injury and repair. Hand therapy and early active range of motion in addition to the advent of various surgical techniques have been shown to reduce the risk of adhesion development. Despite these advances in surgical technique and postoperative rehabilitation protocols, repeat surgical intervention is often indicated to improve decreased range of motion after index repair. Ultrasound is effective in diagnosing flexor tendon adhesions postoperatively. This study presents a protocol for ultrasound-guided hydrodissection allowing for early detection and effective intervention in treating postoperative flexor tendon adhesions. Six patients were consecutively enrolled in the study. All 6 patients had identifiable adhesions noted on ultrasound. All patients reported subjective improvement in gliding and motion. Early diagnosis and intervention using ultrasound-guided hydrodissection may be a safe technique for treating early flexor tendon postoperative adhesions.