Adhesion Issues After Tendon Injury: Insights for Recovery - Plastic Surgery

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Adhesion issues following tendon injuries can significantly impact recovery and functional outcomes. When a tendon is injured, especially in cases where the skin is broken and the tendon is exposed, the healing process can lead to the formation of scar tissue. This scar tissue can sometimes adhere to surrounding structures, leading to restricted movement and pain.
In your case, the presence of a thickened scar, particularly given your predisposition to keloid formation, can indeed contribute to adhesion problems. Keloids and hypertrophic scars are characterized by an overproduction of collagen during the healing process, which can lead to a more pronounced and potentially problematic scar. This thickened scar tissue can restrict the movement of the tendon and surrounding tissues, leading to discomfort and functional limitations.

The formation of adhesions is a common complication after tendon repair surgeries. When tendons are sutured back together, the healing process involves inflammation and the formation of scar tissue. If this scar tissue forms in a way that connects the tendon to adjacent tissues or structures, it can limit the tendon’s ability to glide smoothly during movement, leading to pain and decreased range of motion.

To address your concerns about the possibility of surgical intervention to remove adhesions, it is indeed an option. Surgical procedures to release adhesions can help restore mobility and alleviate pain. However, it is essential to consider a few factors before proceeding:
1. Assessment of Adhesions: A thorough evaluation by an orthopedic surgeon or a specialist in hand surgery is crucial. They can assess the extent of the adhesions and determine whether surgical intervention is appropriate.

2. Timing of Surgery: If the adhesions are causing significant functional impairment and pain, and conservative treatments (such as physical therapy) have not yielded satisfactory results, surgery may be warranted. However, it is essential to allow adequate time for the initial surgical site to heal before considering a second surgery.

3. Rehabilitation Post-Surgery: If you undergo surgery to remove adhesions, a structured rehabilitation program will be critical for optimal recovery. This may include physical therapy focused on improving range of motion, strength, and function.

4. Scar Management: Given your history of keloid formation, it may be beneficial to discuss scar management strategies with your healthcare provider. Techniques such as silicone gel sheets, pressure garments, or corticosteroid injections may help minimize scar formation and improve the overall appearance and function of the scar.

5. Alternative Therapies: In addition to surgical options, other treatments such as physical therapy, ultrasound therapy, or even modalities like dry needling may help in managing adhesion-related issues.

In conclusion, while adhesions following tendon injuries can be a significant barrier to recovery, there are options available to address these issues. Consulting with a specialist who can provide a comprehensive evaluation and tailored treatment plan is essential for achieving the best possible outcome. Remember, recovery from tendon injuries can be a gradual process, and patience, along with adherence to rehabilitation protocols, is key to regaining function and minimizing complications.