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Report 41

Watanabe, Gerald B. Room No. 431

Hospital No. 532086

Operative Report

PREOPERATIVE DIAGNOSIS: Flexor tendon adherent in right little finger, extensor habitus, right little finger.

POSTOPERATIVE DIAGNOSIS: Flexor tendon adherent in right little finger, extensor habitus, right little finger.

OPERATION: Tenolysis right little finger, flexor, in finger, palm and wrist; excision of sublimis tendon; excision of lumbrical, right little finger.

PROCEDURE: Under satisfactory anesthesia, the right upper extremity was prepared with betadine and draped in the usual manner. The limb

was exsanguinated with an esmarch bandage, and the previously applied tourniquet inflated to 250 mm Hg pressure. A brunner zigzag incision was fashioned, extending from the distal segment of the little finger to the proximal palm. The flexor digitora profundus and sublimis were seen to be adherent within the finger and distal palm with fairly dense adhesions. The tendon of the flexor digitorum profundus was lysed through its extent, with care being taken to preserve pulleys. The flexor sublimis tendon which was significantly scarred, was excised. Because of the patient’s extensor habitus, the lumbrical muscle was excised in an attempt to diminish the extensor thrust at the middle joint level. A separate transverse incision was made at the wrist and traction applied to the little finger flexor digitorum profundus tendon. With proximal traction, the finger pulp reached the midpalm at the termination of the procedure with ease. The tourniquet was released and hemostasis obtained. The four wounds were sutured with fine vertical mattress sutures of prolene. Dry sterile dressings were applied and a modified Jones position utilized, incorporating a dorsal plaster-of-paris splint.

Rapid mobilization postoperatively is anticipated.

The patient, who tolerated the procedure well, left the operating room in satisfactory condition.

Joan R. Richards MD

student’s initials

D: 10/14/20XX

T: 10/14/20XX