The total anterior tenoarthrolysis in the treatment of the stiffness in flexion of the fingers

摘要

The total anterior tenoarthrolysis (TATA) allows tenolysis, arthrolysis and skin repair in the same operation, avoiding combined different surgical procedures. The authors present a series of personal and original indications and propose a partial anterior tenoarthrolysis (PATA) for the treatment of isolated stiffness of the proximal interphalangeal joint or in the presence of less severe flexion contractures. The etiology was wide various, and the TATA revealed to be extremely useful also in tetraplegia or spasticity, permitting respectively the following tendon transfer and the hygienic improvement, and in the presence of global stiffness following complex lesions, reflex sympathetic algodystrophy or psychotic contracture. The performed additional procedures, at the skin and tendon level, further expanded the inclusion criteria. In the presence of appropriate indications, the TATA is a very useful tool with excellent outcome and represents a salvage procedure in the more severe deformities, avoiding joint fusion, with shortage of the digit, or amputation.