网球肘开放松解术后功能预后评估：哪些是预测参数？

Department of Orthopaedic Surgery, Singapore General Hospital, Outram Road, Singapore 169608.

Singapore Med J. 2011 Feb;52(2):73-6.

INTRODUCTION

Open surgical release remains the gold standard for treatment of recalcitrant lateral epicondylitis (tennis elbow). We aimed to evaluate the potential impact of perioperative factors on outcome after open surgical release for tennis elbow.

METHODS

All patients without elbow dislocation who underwent open surgical release for tennis elbow from January 2000 to June 2006 were included in the study. Comorbidities and associated pathologies of the upper limb as well as postoperative pain score, range of motion, evidence of instability, recurrence and other complications were noted.

RESULTS

There were 37 female and 24 male patients aged 22-60 (44.95 +/- 7.34) years. Five (8.1 percent) patients had diabetes mellitus. The mean duration of symptoms before surgery was 16.8 +/- 15.3 (range 2-84) months. The average duration of follow-up was 23.0 +/- 34.5 (range 0.4-206) months. Overall, 59 (96.7 percent) patients reported improvement of symptoms post surgery. Median grip strength on the operated and unoperated sides were 25.5 +/- 9.0 (range 10.5-44.0) KgN and 23.7 +/- 9.1 (range 9.3-41.5) KgN, respectively. Patients with diabetes mellitus had significantly higher pain scores (2.80 versus 0.36, p-value less than 0.01, 95 percent confidence interval [CI] 1.2-3.7), reduced grip strength (0.91 KgN versus 1.06 KgN, p-value is 0.038, 95 percent CI 0.29-0.01) and higher recurrence rates (40 percent versus 7.7 percent, p-value is 0.018).

CONCLUSION

Diabetes mellitus has a negative effect on surgical outcome in terms of pain scores, grip strength ratio and recurrence rate. This should be reiterated during preoperative counselling.

简介

对于顽固性外上髁炎（网球肘），开放式手术松解仍然是金标准。我们旨在评估围手术期因素对网球肘开放式手术松解后结果的潜在影响。

方法

本研究纳入了 2000 年 1 月至 2006 年 6 月期间接受开放式手术松解治疗网球肘且无肘关节脱位的所有患者。记录合并症和上肢相关病变，以及术后疼痛评分、活动范围、不稳定证据、复发和其他并发症。

结果

患者中女性 37 例，男性 24 例，年龄 22-60 岁（44.95 +/- 7.34）岁。5 例（8.1%）患者患有糖尿病。术前症状持续时间平均为 16.8 +/- 15.3 个月（范围 2-84 个月）。平均随访时间为 23.0 +/- 34.5 个月（范围 0.4-206 个月）。总体而言，59 例（96.7%）患者术后症状改善。手术侧和非手术侧的平均握力分别为 25.5 +/- 9.0 千克力（范围 10.5-44.0 千克力）和 23.7 +/- 9.1 千克力（范围 9.3-41.5 千克力）。患有糖尿病的患者疼痛评分显著更高（2.80 比 0.36，p 值小于 0.01，95%置信区间 [CI] 1.2-3.7），握力降低（0.91 千克力比 1.06 千克力，p 值为 0.038，95%CI 0.29-0.01），复发率更高（40%比 7.7%，p 值为 0.018）。