Mercy Hospital and Marinoto Clinic, Dunedin, New Zealand.
J Shoulder Elbow Surg. 2010 Apr;19(3):363-7. doi: 10.1016/j.jse.2009.09.008. Epub 2009 Dec 11.
Since its first description, the pathology, natural history, and treatment of lateral epicondylitis have remained controversial. For patients in who conservative management fails, surgery remains an option. The optimal method of surgery remains debatable and is further confounded by a relative lack of long-term follow-up studies.
This study describes a modification of the Nirschl surgical technique and presents its long-term results. Patients undergoing this open technique were reviewed by use of the Hospital for Special Surgery and Mayo elbow performance assessment tools, as well as having grip strength and subjective outcome recorded.
From June 1986 to December 2001, 158 consecutive patients (171 elbows) underwent surgery in a single-surgeon series. Of these patients, 137 (86.7%) were available for follow-up at a mean of 9.8 years. The mean age of the group was 42 years. Subjectively, the results were good to excellent in 94.6% of patients and in 92.6% to 94.0% of patients by use of the Hospital for Special Surgery and Mayo scores, respectively. No differences were noted in grip strength. No patient required revision surgery.
This repeatable open technique offers excellent results with a low rate of complications at a mean follow-up of 9.8 years. These results compare favorably in terms of numbers followed up, length of follow-up, and outcome and offer strong evidence of its efficacy.
自首次描述以来，外侧上髁炎的病理学、自然史和治疗方法一直存在争议。对于保守治疗失败的患者，手术仍然是一种选择。手术的最佳方法仍存在争议，并且由于缺乏长期随访研究而进一步复杂化。
本研究描述了 Nirschl 手术技术的改良，并介绍了其长期结果。通过使用矫形外科医院和 Mayo 肘部表现评估工具对接受这种开放式手术的患者进行了回顾，并记录了握力和主观结果。
从 1986 年 6 月到 2001 年 12 月，158 例连续患者（171 个肘部）在单外科医生系列中接受了手术。这些患者中有 137 例（86.7%）平均随访 9.8 年。该组的平均年龄为 42 岁。主观上，94.6%的患者结果良好至优秀，92.6%至 94.0%的患者分别使用矫形外科医院和 Mayo 评分。握力无差异。没有患者需要进行翻修手术。
这种可重复的开放式技术在平均随访 9.8 年的时间内提供了出色的结果，并发症发生率低。就随访人数、随访时间和结果而言，这些结果都非常出色，为其疗效提供了有力证据。
