Tenolysis is a surgical procedure in which tendons that have become stuck or bound down by surrounding scar tissue are freed, in order to restore movement in the fingers or other joints.
What happens during tenolysis?
Sometimes, after an injury, operation, or inflammation, tendons in the hand, fingers, or occasionally other parts of the body can no longer glide freely. The problem occurs when scar tissue forms around the tendon and causes it to stick to the surrounding structures. The result is that the affected fingers can no longer bend or straighten properly, and movement becomes painful or even impossible.
In such cases, tenolysis may become necessary. This is a carefully targeted operation in which the troublesome scar tissue is gently removed. The aim is to free the tendon so that it can move as smoothly as possible again. Particularly after complicated fractures, deep cuts, or following tendon repair surgery, this procedure is sometimes the only way to regain movement.
Why do tendons become stuck in the first place?
Tendons are the strong, fibrous cords that connect muscles to bones. They run through narrow channels called tendon sheaths, where they are surrounded by a thin layer of lubricating fluid. After an injury or operation, the body tries to repair the affected area. During this process, too much scar tissue can form. This tissue connects the tendon to its surroundings and prevents it from gliding as it normally would. This happens most often with the flexor tendons of the fingers. Even small areas of adhesion are enough to significantly limit function.
When is tenolysis the right choice?
Restricted movement is not always an immediate reason for surgery. Usually, the first step is to try targeted physiotherapy and to allow time for the adhesions to resolve. Only when these measures have not produced results over a longer period, and movement remains severely restricted, is tenolysis considered. The procedure is recommended especially when the tendon itself has healed but is being blocked by scar tissue. The decision is always made by an experienced hand surgeon following a thorough examination.
How does the procedure work?
Tenolysis usually takes place under local anaesthetic or a short general anaesthetic. The affected area is carefully opened so that the tendon can be seen. The surgeon then removes the scar tissue that is holding the tendon in place. Precision is essential, as the surrounding nerves and blood vessels must not be damaged. Often, during the operation itself, the surgeon checks whether the finger can move more freely.
Post-operative treatment begins directly after the procedure, usually on the same day. The aim is to prevent new adhesions from forming. This is why early, targeted movement therapy is so important, guided by experienced physiotherapists or occupational therapists.
What are the risks?
As with any surgical procedure, tenolysis carries certain risks. These include bleeding, infection, or renewed scar formation. In rare cases, nerves or blood vessels may be injured. The greatest risk is that adhesions form again after the operation. This is why consistent follow-up treatment is so important. Overall, tenolysis is considered a safe procedure that is performed regularly in specialist centres.
What can you do yourself?
After tenolysis, your own effort and commitment are crucial to a good outcome. Movement therapy begins shortly after the procedure. It is important to carry out the exercises recommended by your doctor or therapist regularly, even if it feels uncomfortable at first. Waiting too long or keeping the hand too still risks new adhesions forming again. Cooling, elevating the hand, and following wound care advice all support healing. If you are in pain or have any concerns, always speak to your treating team.
What are the prospects after tenolysis?
Many people notice a clear improvement in movement after the procedure. The sooner tenolysis is carried out, the better the results tend to be. However, success also depends on how long the adhesions have been present and how consistently the follow-up treatment is carried out. In some cases, a degree of restriction remains, especially if the tendon has been blocked for a long time or if other injuries are present. Overall, tenolysis offers a good chance of restoring function to the affected hand or finger.
Frequently asked questions about tenolysis
Is the procedure painful? During the operation itself, you will not feel any pain thanks to the anaesthetic. Afterwards, there may be some wound pain, but this can usually be managed well with simple painkillers.
How long does recovery take? The wound itself usually heals within one to two weeks. However, it may take several weeks to regain full movement. The exact length of time depends on your individual situation and how actively you take part in your follow-up treatment.
Can adhesions come back? Yes, in rare cases scar tissue can form again. The risk can be significantly reduced by starting movement therapy early and sticking to it consistently.
When can you return to work? This depends on the type of work involved. Light tasks are often possible again after two to three weeks, while physically demanding jobs may take longer. Your treating doctor will give you individual guidance on this.
If you are unsure whether tenolysis is necessary or what alternatives exist, it is worth speaking to a specialist hand surgeon. Together, you can decide which approach makes sense and offers the best chance of success.
