Hospital for Special Surgery, New York, New York.
Sports Health. 2012 Sep;4(5):384-93. doi: 10.1177/1941738112454651.
Elbow tendinopathy is a common cause of pain and disability among patients presenting to orthopaedic surgeons, primary care physicians, physical therapists, and athletic trainers. Prompt and accurate diagnosis of these conditions facilitates a directed treatment regimen. A thorough understanding of the natural history of these injuries and treatment outcomes will enable the appropriate management of patients and their expectations.
The PubMed database was searched in December 2011 for English-language articles pertaining to elbow tendinopathy.
Epidemiologic data as well as multiple subjective and objective outcome measures were investigated to elucidate the incidence of medial epicondylitis, lateral epicondylitis, distal biceps and triceps ruptures, and the efficacy of various treatments.
Medial and lateral epicondylitis are overuse injuries that respond well to nonoperative management. Their etiology is degenerative and related to repetitive overuse and underlying tendinopathy. Nonsteroidal anti-inflammatory drugs and localized corticosteroid injections yield moderate symptomatic relief in short term but do not demonstrate benefit on long-term follow-up. Platelet-rich plasma injections may be advantageous in cases of chronic lateral epicondylitis. If 6 to 12 months of nonoperative treatment fails, then surgical intervention can be undertaken. Distal biceps and triceps tendon ruptures, in contrast, have an acute traumatic etiology that may be superimposed on underlying tendinopathy. Prompt diagnosis and treatment improve outcomes. While partial ruptures confirmed with magnetic resonance imaging can be treated nonoperatively with immobilization, complete ruptures should be addressed with primary repair within 3 to 4 weeks of injury.
肘肌腱病是骨科医生、初级保健医生、物理治疗师和运动训练师接诊患者时常见的疼痛和功能障碍原因。这些疾病的快速准确诊断有助于制定针对性的治疗方案。深入了解这些损伤的自然病史和治疗结果将有助于对患者及其期望进行适当的管理。
2011 年 12 月，在 PubMed 数据库中搜索了与肘肌腱病相关的英文文章。
调查了流行病学数据以及多种主观和客观的结果测量指标，以阐明内侧上髁炎、外侧上髁炎、肱二头肌和三头肌远端撕裂的发生率，以及各种治疗方法的疗效。
内侧和外侧上髁炎是过度使用损伤，对非手术治疗反应良好。它们的病因是退行性的，与重复过度使用和潜在的肌腱病有关。非甾体抗炎药和局部皮质类固醇注射可在短期内获得中度症状缓解，但在长期随访中无获益。富含血小板的血浆注射可能对慢性外侧上髁炎有益。如果 6 至 12 个月的非手术治疗失败，则可进行手术干预。相比之下，肱二头肌和三头肌远端肌腱撕裂具有急性创伤性病因，可能与潜在的肌腱病叠加。及时诊断和治疗可改善预后。虽然经磁共振成像证实的部分撕裂可以通过固定进行非手术治疗，但完全撕裂应在受伤后 3 至 4 周内进行初次修复。
