Goldberg E J, Abraham E, Siegel I
University of Illinois, Department of Orthopaedics, Chicago, Illinois 60680.
Clin Orthop Relat Res. 1988 Aug(233):208-12.
This retrospective study reports on the surgical treatment of chronic lateral epicondylitis. Thirty-four elbows were followed for an average of four years after surgery. Only those patients with persistent or recurrent local pain and muscle weakness, nonresponsive to conservative measures for at least six months, were considered for surgery. A complete release of the common extensor tendon permitted about a 1-cm distal muscle slide to a new resting length. The results indicate 73% excellent, 18% good, and 9% failures. Complete pain relief was obtained in 25 of 34 (73%) elbows, and eight of 33 (24%) had minimal residual symptoms that did not impair activity. There was no loss of range of motion in any patient, and 33 of 34 (97%) elbows had improved extremity muscle strength. All but one patient (97%) returned to their regular jobs on the average of five weeks after surgery. The gross and histologic findings were consistent with a degenerative process. This relatively simple outpatient procedure using Bier block anesthesia is recommended for carefully selected patients.
这项回顾性研究报告了慢性外侧上髁炎的手术治疗情况。34例肘部患者术后平均随访4年。仅那些持续或反复出现局部疼痛和肌肉无力、对保守治疗至少6个月无反应的患者才考虑手术。对伸肌总腱进行完全松解可使肌肉向远侧滑动约1厘米至新的静息长度。结果显示，73%为优，18%为良，9%为失败。34例肘部中有25例（73%）疼痛完全缓解，33例中有8例（24%）有轻微残留症状，但不影响活动。所有患者均无活动范围丧失，34例肘部中有33例（97%）肢体肌肉力量得到改善。除1例患者外（97%），所有患者术后平均5周恢复正常工作。大体和组织学检查结果与退变过程一致。对于经过仔细挑选的患者，推荐采用静脉局部麻醉的相对简单的门诊手术。
