SURGICAL AND TREATMENT PURPOSE To restore flexor tendon function if tendon gliding has been compromised or lost because of scar adhesions. The surgical approach may be very localized or very extensive, depending on the preoperative and intraoperative assessments. Sharp dissection is used to minimize tissue trauma. Care is taken to preserve the critical portions of the digital pulley systems. Adequacy of the tendon release may be assessed by two intraoperative methods. In an awake patient and with the use of local anesthesia, active excursion may be demonstrated by the patient. If general anesthesia is used, the surgeon may test excursion by retracting the tendons proximal to the zone of scarring addressed. Early therapy is used to minimize subsequent development of tendon adhesions. Extensive surgical release may weaken the tendon or compromise blood supply to the newly freed tendon. These conditions create a risk of postoperative tendon rupture. Careful and attentive postoperative care is required to achieve an optimal goal while avoiding complications.