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桡侧腕短伸肌松解术后桡骨外侧髁炎患者的腕背伸力量变化

Wrist extension strength changes after extensor carpi radialis brevis release in the lateral epicondylitis.

作者信息

Kim Yunseop, Kang Sung Jin, Lee Seoung Joon

机构信息

Department of Orthopaedic Surgery, Center for Hand and Elbow Surgery, Konkuk University School of Medicine, 120-1 Neungdong-ro (Hwayang-dong), Gwangjin-gu, Seoul, 143-729, Korea.

出版信息

Int Orthop. 2025 Feb;49(2):461-466. doi: 10.1007/s00264-024-06356-5. Epub 2024 Nov 4.

Abstract

PURPOSE

Lateral epicondylitis (LE) is often attributed to degenerative changes and microscopic ruptures in the extensor carpi radialis brevis (ECRB). Surgical procedures, such as arthroscopic or open ECRB release, are commonly used to address this condition. However, there is limited research on changes in wrist muscle strength and their clinical impact after ECRB release. This study aims to investigate the changes in wrist extension strength following ECRB release in patients with lateral epicondylitis.

METHODS

A retrospective study was conducted involving thirty-six right-handed patients who underwent open ECRB release at a single institution. Wrist extension strength was measured using a Biodex system during both the initial and two-year follow-up clinical visits. Additionally, clinical outcomes were assessed using the Disabilities of the Arm, Shoulder, and Hand (DASH) score, pain visual analog scale (pain VAS), grip strength, and wrist extension strength. Correlations among these factors were analyzed to explore potential associations.

RESULTS

Significant improvements were observed in all clinical outcomes, including grip strength and wrist extension strength, following ECRB release. However, at the two-year follow-up, a statistically significant decrease in wrist extension strength was noted compared to the unaffected arm. Despite this decrease, there were no adverse effects on the clinical outcomes (DASH, pain VAS) or grip strength.

CONCLUSION

Our study demonstrated a decrease in wrist extension power following ECRB release, which did not significantly impact clinical outcomes. Therefore, we recommend that clinicians inform patients about the potential reduction in wrist extension strength and incorporate wrist extension strengthening exercises into postoperative rehabilitation protocols to facilitate recovery to normal levels.

LEVEL OF EVIDENCE

III.

摘要

目的

外侧上髁炎(LE)常归因于桡侧腕短伸肌(ECRB)的退行性改变和微观撕裂。诸如关节镜下或开放性ECRB松解术等外科手术常用于治疗这种疾病。然而,关于ECRB松解术后腕部肌肉力量变化及其临床影响的研究有限。本研究旨在调查外侧上髁炎患者ECRB松解术后腕部伸展力量的变化。

方法

进行了一项回顾性研究,纳入了在单一机构接受开放性ECRB松解术的36例右利手患者。在初次临床就诊和两年随访时,使用Biodex系统测量腕部伸展力量。此外,使用手臂、肩部和手部功能障碍(DASH)评分、疼痛视觉模拟量表(疼痛VAS)、握力和腕部伸展力量评估临床结果。分析这些因素之间的相关性以探索潜在关联。

结果

ECRB松解术后,所有临床结果,包括握力和腕部伸展力量,均有显著改善。然而,在两年随访时,与未受影响的手臂相比,腕部伸展力量出现了统计学上的显著下降。尽管有这种下降,但对临床结果(DASH、疼痛VAS)或握力没有不良影响。

结论

我们的研究表明,ECRB松解术后腕部伸展力量下降,但这并未对临床结果产生显著影响。因此,我们建议临床医生告知患者腕部伸展力量可能会降低,并将腕部伸展强化练习纳入术后康复方案,以促进恢复到正常水平。

证据水平

III级。

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