The surgical treatment of chronic lateral humeral epicondylitis by common extensor release.

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.