Perioperative management - Removal of a tendon sheath hygroma/Extensor tendon synovectomy with retinaculum plasty

• Pain and swelling
• Failed conservative therapy attempt over 6 months

• Local or general conditions that surgically or anesthesiologically contraindicate an elective operation or are amenable to preoperative improvement

• Clinical examination:
  → Inspection/Palpation of a painful thickening along the course of the 4th SSF, which moves with the extensor tendons
• Ultrasound: Detection of a fluid-filled cavity with connection to the extensor tendons
• If necessary, MRI in case of unclear findings

• no special preparation of the patient necessary
• generally outpatient procedure
• Clarification of contraindication for bloodless field (e.g. existing shunt in dialysis)

Information on

• surgical method
• extension procedure such as e.g. tendon suture, tendon reconstruction, retinaculum plasty

• general surgical risks
  • wound healing disorder
  • tendon injury
  • functional deficit wrist/hand
  • CRPS = Sudeck's disease

• specific surgical risks
  • injury to the extensor tendons
  • protracted scar pain (usually subsides after 6 months)
  • persistent complaints
  • revision surgery
  • secondary tendon rupture