Postoperative management of functionally restrictive muscular adherence, a corollary to surgical tenolysis: a case report.
After a surgical release of adhered nongliding tendons, early active mobilization is encouraged to prevent the reformation of unfavorable adhesions that would limit functional tendon excursion. These restricting adhesions can also occur in non-synovial regions, such as within the flexor mass in the forearm. A "myolysis," or release of muscle fibers from tethering adhesions, can be performed surgically to restore the muscle's gliding and lengthening properties. Postoperative management consists of treatment techniques that include low-load prolonged stress, differential tendon gliding, and active-resistive exercises, all of which are effective in restoring and maximizing a patient's active and passive range of motion to allow optimal mobility and performance. This case study demonstrates the successful management of a patient following a surgical myolysis, utilizing treatment techniques conceptually derived from postoperative tenolysis rehabilitation.
Philadelphia Hand Center, Pennsylvania 19107, USA. calba@earthlink.net
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D000328:Adult; D003286:Contracture / Q000209:etiology / Q000534:rehabilitation; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods; D017102:Fracture Healing; D006227:Hand Deformities, Acquired / Q000209:etiology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D009788:Occupational Therapy / Q000295:instrumentation / Q000379:methods*; D019637:Orthopedic Procedures / Q000009:adverse effects* / Q000379:methods; D011885:Radius Fractures / Q000175:diagnosis / Q000601:surgery*; D016059:Range of Motion, Articular; D013710:Tendons / Q000601:surgery*; D013997:Time Factors; D000267:Tissue Adhesions / Q000209:etiology / Q000534:rehabilitation* / Q000601:surgery; D016896:Treatment Outcome