Excision of Lesion of Tendon Sheath or Joint Capsule

Excision of Lesion of Tendon Sheath or Joint Capsule is the removal of the most common tumor in the hand and wrist. These are benign sacs of gelatinous fluid that form off of a joint or tendon sheath. They are seen frequently in the wrist but can also occur around finger joints. They form when a portion of the joint capsule or tendon sheath starts ballooning out and becomes filled with the fluid that lubricates the joint or tendon. A tendon is a tough band of fibrous tissue that connects muscle to bone. Tendons are surrounded by specialized tissues (tendon sheath or epitenon) that protect and help to nourish the tendons. Sometimes, the sheath can cause pressure on the tendon, limiting movement or causing pain

Preoperative

Your health care provider will talk to you about how to prepare for surgery. You may be told not to eat or drink anything after midnight on the day of your surgery. You will be told what medications to take or not take on the day of your surgery before surgery; you will need to obtain clearance from your regular doctor if you have medical problems. You may be required to obtain some basic tests for screening before the surgery. Basic blood tests, a chest x-ray, and an EKG may be required depending on your health.

Excision of Lesion of Tendon Sheath or Joint Capsule procedure

Local, regional, or general anesthesia may be required, depending on the location of the involved tendon. The surgery may be performed either endoscopically (using a special operating microscope and miniature instruments) or through an open incision. An incision is made over the tendon. The sheath and the tendon are explored, isolating and protecting nerve and blood vessel branches. The sheath is then either cut away (excised) entirely or loosened (released) by making a cut on one side along its length. Tendon function is evaluated with passive motion, and the wound is closed with sutures.

Recovery

Following a Excision of Lesion of Tendon Sheath or Joint Capsule mass or tumor at the wrist level,

A bulky compressive dressing will be applied. Your physician or therapist will initiate exercises early in the postoperative period. This is done to prevent the development of possible stiffness and prevent limitations of wrist motion. Between periods of exercise, a splint may be worn to provide rest for the joint, or one may be worn to assist in regaining motion. Usual recovery time following surgery for the removal of most Lesions of the Tendon Sheath, or Joint Capsule procedures ranges from two to three weeks for fingers, and six to eight weeks involving the wrist or hand.

 Risk

As with any surgical procedure, complications can occur, some possible complications may include, but are not limited to the following:

• Infection
• Damage to nerves, tendons or cartilage
• Stiffness or loss of joint motion
• Tumor, Mass may reappear, though this is uncommon

Stiffness can be addressed post-surgery with rehabilitation