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The treatment of therapy-resistant lateral epicondylitis by denervation

  • Published:
Orthopaedics and Traumatology

An Erratum to this article was published on 01 March 2001

Summary

Objectives

Relief of pain in therapy-resistant lateral epicondylitis through denervation and indirect decompression of the deep branch of the radial nerve through detachment of the supinator muscle only.

Indications

Therapy-resistant, recurrent chronic lateral epicondylitis.

Contraindications

Epicondylitis in the presence of thoracic outlet syndrome.

Proximal compression syndrome of the radial nerve.

Surgical Technique

Interruption of the sensory fibers of the posterior antebrachial cutaneous nerve which run subcutaneously. Exact localization of the lateral collateral branch of the radial nerve and neurotomy 3 to 4 cm proximal to the tip of the epicondyle. Elimination of the anterior sensory fibers of the radial nerve through detachment of the extensor carpi radialis longus. The sensory fibers of the muscular branch of the anconeus are interrupted by the detachment of the distal fibers of the triceps and of the anconeus. Elimination of the recurrent pain fibers of the muscular branches of the supinator and indirect decompression of the deep branch of the radial nerve through detachment of the anterior and lateral origin of the supinator over the distal border of the radial head. All soft tissues are reattached with the exception of the supinator.

Results

After an average of 7.3 (5.25 to 9) years 42 out of 46 patients (91.3%) could be followed up. The assessment criteria of Roles and Maudsley, expanded by us, were applied. In addition, the most important functional tests and the strength were assessed postoperatively. 76.2% of patients had excellent, 16.6% good, 4.8% satisfactory and 2.4% poor results. The average duration of temporary disability amounted to 5.7 (1 to 9.6) weeks.

It is concluded that the pathogenesis of lateral epicondylitis resides in pressure damage to the radial nerve, its fascicles, particularly of C6 and C7, and its branches.

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Authors and Affiliations

  1. Schongauer Straße 2, D-63739, Aschaffenburg, Germany

    Albrecht Wilhelm

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  1. Albrecht Wilhelm
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Additional information

An erratum to this article is available at http://dx.doi.org/10.1007/BF03354256.

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Wilhelm, A. The treatment of therapy-resistant lateral epicondylitis by denervation. Orthop Traumatol 8, 86–97 (2000). https://doi.org/10.1007/BF03181125

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