Tenolysis and capsulectomy after hand fractures

Area of Science:

• Orthopedic Surgery
• Hand Surgery
• Reconstructive Surgery

Background:

• Fracture healing can result in restricted range of motion due to tendon adhesions or hardware.
• Hand therapy is the primary treatment, but may not always restore satisfactory function.
• Surgical salvage procedures are necessary in select cases for functional restoration.

Purpose of the Study:

• To outline operative procedures for salvaging hand function after fracture healing.
• To detail the indications and techniques for tenolysis and capsulectomy.
• To discuss patient selection and risks associated with surgical intervention.

Main Methods:

• Review of established operative procedures for post-fracture motion loss.
• Description of tenolysis (lysis of tendon adhesions) and capsulectomy (joint capsule release).
• Emphasis on preoperative assessment, intraoperative techniques (e.g., local anesthesia), and postoperative management.

Main Results:

• Tenolysis and capsulectomy can effectively address restricted motion caused by adhesions and joint stiffness.
• Local anesthesia allows patient feedback, optimizing surgical precision.
• Successful outcomes depend on patient compliance, fracture healing, and articular surface integrity.

Conclusions:

• Tenolysis and capsulectomy are valuable salvage procedures for complex post-fracture hand dysfunction.
• Careful patient selection, including functional need and realistic expectations, is paramount.
• Alternatives like arthrodesis or amputation may be considered for severely compromised digits.