Gabel G T, Morrey B F
Mayo Clinic, Rochester, Minnesota 55905, USA.
J Bone Joint Surg Am. 1995 Jul;77(7):1065-9. doi: 10.2106/00004623-199507000-00013.
We performed a retrospective review of the long-term results of operative treatment of medial epicondylitis in thirty elbows (twenty-six patients). Sixteen elbows had concomitant ulnar neuropathy. All of the patients had tenderness over the medial epicondyle. The most sensitive provocative maneuver was resisted pronation of the forearm (a positive result for twenty-eight elbows), followed by resisted flexion of the wrist (a positive result for twelve elbows). The operative findings included an inflammatory focus in seventeen elbows and focal ulnar-nerve compression in nine. Débridement of the origin of the flexor-pronator tendon mass, with decompression or transposition of the ulnar nerve when indicated, was associated with an 87 per cent rate (twenty-six elbows) of good or excellent results at an average of seven years (range, two to fifteen years) after the operation. Twenty-four of the twenty-five elbows that had no or mild associated ulnar neuropathy (type-IA or IB medial epicondylitis) had a good or excellent result, while two of the five elbows that had moderate or severe associated ulnar neuropathy (type-II medial epicondylitis) had a good or excellent result. This difference was significant (p = 0.009). Nine patients (nine elbows) needed more than six months before maximum improvement was obtained.
我们对30个肘部（26例患者）的肱骨内上髁炎手术治疗的长期结果进行了回顾性研究。16个肘部伴有尺神经病变。所有患者的肱骨内上髁均有压痛。最敏感的激发动作是前臂抗旋前（28个肘部结果为阳性），其次是腕关节抗屈曲（12个肘部结果为阳性）。手术所见包括17个肘部有炎性病灶，9个肘部有局限性尺神经受压。当有指征时，对屈肌 - 旋前肌腱团块起点进行清创，并对尺神经进行减压或移位，术后平均7年（范围2至15年），优良率为87%（26个肘部）。25个无或轻度相关尺神经病变（IA型或IB型肱骨内上髁炎）的肘部中有24个结果优良，而5个中度或重度相关尺神经病变（II型肱骨内上髁炎）的肘部中有2个结果优良。这种差异具有统计学意义（p = 0.009）。9例患者（9个肘部）需要超过6个月才能获得最大程度的改善。
