Kurvers H, Verhaar J
Department of Orthopaedics, University Hospital Maastricht, The Netherlands.
J Bone Joint Surg Am. 1995 Sep;77(9):1374-9. doi: 10.2106/00004623-199509000-00014.
The results of the operative treatment of medial epicondylitis in forty consecutive elbows (thirty-eight patients) were assessed retrospectively on the basis of the subjective outcome, pain noted during resisted palmar flexion of the hand and wrist, satisfaction of the patient, and grip strength. The mean age of the patients at the time of the operation was forty-two years (range, twenty-two to fifty-six years). Coexistent ulnar neuritis was identified preoperatively in twenty-four elbows. The operative procedure involved release of the attachment of the common flexor muscle of the forearm at the medial epicondyle in all of the elbows and release of the retinaculum over the cubital tunnel in seventeen of the twenty-four elbows that had coexistent ulnar neuritis. The patients were followed for a mean of forty-four months (range, twenty-four to sixty-seven months). Twenty-five elbows had a good over-all subjective outcome. The preoperative pain had resolved in twenty-eight elbows. The over-all subjective outcome was less favorable for the elbows that had had coexistent ulnar neuritis (p < 0.05). Eleven of the sixteen elbows that had had isolated medial epicondylitis and had been treated with a flexor release were free of symptoms at the time of follow-up, compared with only three of the twenty-four elbows that had had coexistent ulnar neuritis. This difference was significant (p < 0.01). Moreover, in fifteen elbows, the symptoms of ulnar neuritis persisted. There was no difference in grip strength between the treated and contralateral extremities.(ABSTRACT TRUNCATED AT 250 WORDS)
回顾性评估连续40例(38名患者)肘部内侧上髁炎手术治疗的结果,评估依据包括主观结果、手部和腕部抗掌屈时的疼痛、患者满意度以及握力。手术时患者的平均年龄为42岁(范围22至56岁)。术前在24例肘部发现并存尺神经炎。所有肘部的手术操作均包括松解前臂屈肌总腱在内侧上髁的附着点,24例并存尺神经炎的肘部中有17例松解了肘管上的支持带。对患者进行了平均44个月(范围24至67个月)的随访。25例肘部总体主观结果良好。28例肘部术前疼痛已缓解。并存尺神经炎的肘部总体主观结果较差(p<0.05)。16例单纯内侧上髁炎且接受屈肌松解治疗的肘部中有11例在随访时无症状,而24例并存尺神经炎的肘部中只有3例无症状。这种差异具有显著性(p<0.01)。此外,15例肘部尺神经炎症状持续存在。治疗侧与对侧肢体的握力无差异。(摘要截短至250字)