What is Flexor Tenolysis?

Flexor tenolysis is a surgical procedure performed to release adhesions (scar tissue) that have formed around the flexor tendons in the hand, preventing normal gliding and finger movement. These adhesions can develop after hand trauma or previous surgery, such as flexor tendon repair.

The goal of tenolysis is to restore smooth tendon movement and improve active finger motion, especially when conservative therapy fails to yield progress.

Causes

Flexor tenolysis may be indicated when scar tissue limits tendon motion, typically due to:

• Previous tendon repair surgery

• Crush injuries or deep lacerations

• Prolonged immobilization

• Incomplete healing after flexor tendon injuries

• Fibrosis from infection or inflammatory conditions

Signs & Symptoms

Patients who may benefit from flexor tenolysis often present with:

• Inability to fully bend or straighten the affected finger(s)

• Stiffness despite months of therapy

• Weak grip strength or lack of dexterity

• Absence of smooth tendon glide with movement

• Tightness or “tethering” sensations during flexion

Diagnosis

At Katranji Hand Center, diagnosis involves:

• Detailed patient history and previous surgical notes

• Physical examination – assessing passive vs. active range of motion

• Ultrasound or MRI (in select cases) – to visualize adhesions and tendon continuity

Tenolysis is considered only when the tendon is intact and therapy has plateaued.

Treatment Options

Surgical Procedure

• Performed under local or regional anesthesia, often with the patient awake to assess real-time finger movement

• A small incision is made along the previous surgical scar

• Adhesions around the flexor tendon are carefully dissected and released

• The tendon is tested intraoperatively for smooth gliding

Surgeons at Katranji Hand Center use precise surgical techniques to minimize trauma and optimize outcomes.

Postoperative Rehabilitation

• Therapy begins immediately, often within 24–48 hours

• Early motion is critical to prevent new adhesions from forming

• Custom splints may be used to protect the repair while promoting mobility

• Close collaboration with certified hand therapists ensures proper guidance

Recovery typically spans 6 to 12 weeks, with continued gains possible for several months.

Associated Risks

Potential risks of flexor tenolysis include:

• Tendon rupture (rare but serious)

• Reformation of adhesions

• Infection

• Nerve or vessel injury

• Incomplete improvement in motion

Prognosis

Flexor tenolysis can significantly improve hand function and quality of life—particularly when performed at the right time. Outcomes are best in motivated patients who adhere to rigorous post-op therapy. At Katranji Hand Center, our multidisciplinary approach maximizes the chances of a successful recovery.