Five cases of tennis elbow seen during the time period from Jaunary 1983 to January 1985 had operative treatment. Of the five clinical cases, four elbows in three patients were treated with Nirschl and Pettrone operation. This operative technique included exposure of the extensor carpi radialis brevis, excision of the identified lesion, and repair. The following results were obtained. 1. Correct analysis of the patient's emotional stability was essential prior to undertaking surgical procedure for tennis elbow. 2. The results of Nirschl and Pettrone operation were graded as excellent in three elbows and fair in one.
Elbow ; Humans ; Mortuary Practice ; Tennis Elbow ; Tennis

Background: Lateral epicondylalgia (LE) is a cumulative strain injury affecting the common extensor origin of the elbow, manifesting as lateral elbow pain. Tightness of the fascia connecting the lateral elbow area with the shoulder area was assumed as potential source of LE. Limitation in shoulder rotatory motions may be associated with painful LE elbows. Aim: To determine the difference on shoulder rotatory motions between sides of symptomatic and asymptomatic elbows. Methods: Eligible participants had at least one elbow that tested positive for Cozen, Mill, or Maudsley’s test. Using a universal goniometer, a blinded assessor measured the participants’ active and followed by passive shoulder internal and external rotation. The primary investigator tested the external rotation followed by internal rotation of the right upper extremity, then subsequently the left upper extremity of healthy participants both passively and actively Results: The assessor showed excellent intra-tester reliability in measuring active and passive shoulder rotatory motions of 20 asymptomatic right upper extremities (ICC=0.98). Twenty-seven (27) participants (3 males, 24 females) with a mean (95%CI) age of 54 (49-58) years old were enrolled in the study. The mean visual analogue scale of the patients was 6.53 (5.91- 7.13), with mean (95%CI) duration of 96 (50-142) weeks. Based on hand dominance and side of LE, significant difference was found in active and passive shoulder internal rotation (p>0.05). Conclusion Shoulder active and passive internal rotations were significantly associated with hand dominance in patients with LE. Tightness of the fascia and muscle in the shoulder and painful LE elbow may underpin the decreased shoulder rotatory motions.
Tennis Elbow ; Shoulder ; Fascia

The symptom of tennis elbows is a syndrome of pain and point tenderness localized at either extensor or flexor epicondylar origin at the elbow. One hundred and ninety-seven cases of tennis elbow seen from Jan. 1985 to Dec. 1988 were managed by mean of conservative treatments firstly such as rest, medication, immobilization, P-T and local steroid injection. Among the 197 cases, 32 cases were treated with Nirschl and Pettrone operation. The results were summerized as follows, l. Of 197 cases, 139 cases were female, and 96 cases were in the age group 41 to 50. 2. One hundred and thirty-two cases were housewives. 3. Only 11 cases had history of sports. 4. By Nirsch and Pettrone assessment, the end results of conservative treatment were excellent and good in 117 cases(59.4%), fair and failure in 80 cases(41.2%). 5. Among the 11 cases treated with Nirsch and Pettrone operation, excellent result was obtained in 6 cases, good in 3 cases, fair in one case and failure in one case.
Clinical Study ; Elbow ; Female ; Humans ; Immobilization ; Sports ; Tennis Elbow ; Tennis

Humans ; Rotation ; Tennis Elbow ; therapy ; Traction ; methods

PURPOSE: To evaluate clinical results of a single percutaneous injection of platelet-rich plasma in patients with refractory lateral epicondylitis. MATERIALS AND METHODS: Between Jan and Dec 2009, fifteen patients (5 male, 10 female) received a diagnosis of lateral epicondylitis of the elbow and were evaluated in this study. Their average age was 43.5 years. All patients were initially given a variety of non-surgical treatments for more than 1year. All patients were considering surgery. These patients were given a single percutaneous injection of 3cc of platelet-rich plasma. To assess pain, we used a visual analogue scale (VAS) at rest and during work & the Patient-Rated Tennis Elbow Evaluation (PRTEE) score. We compared the score before treatment with scores 4 and 12 weeks after treatment. RESULTS: Average VAS scores at rest improved from 4.6 before treatment to 2.5 at week 4, and 1.8 at week 12. The average VAS score while working also improved from 7.8 before treatment to 6.2 at week 4, and 4.25 at week 12. The average PRTEE score improved from 60.13 before treatment to 46.12 at week 4 and 24.6 at week 12. CONCLUSION: Treatment using a single percutaneous injection of platelet-rich plasma in patients with refractory lateral epicondylitis appears to be an effective treatment modality. Platelet-rich plasma should be considered before surgical intervention.
Elbow ; Humans ; Male ; Platelet-Rich Plasma ; Tennis Elbow

OBJECTIVETo explore an effective method for treatment of tennis elbow.

METHODSOne hundred and twenty-eight cases were randomly divided into a treatment group and a control group, 64 cases in each group. The treatment group were treated by electroacupuncture at Hegu (LI 4) and Taichong (LR 3), combined with cake-seperated moxibustion at Ashi points and Shousanli (LI 10) in the affected elbow, and the control group by routine block treatment of 1 mL lidocane and 25 mg prednisone.

RESULTSThe cured rate and the effective rate were 40.6% and 93.7% in the treatment group, and 25.0% and 78.1% in the control group, respectively, with a significant difference between the two groups (P < 0.05).

CONCLUSIONElectroacupuncture combined with cake-separated moxibustion is an effective method for tennis elbow.

Elbow Joint ; surgery ; Humans ; Tennis Elbow ; surgery ; Traction ; methods

Tennis elbow is common, and offen disabling problem even in daily living;conservative treatments commonly make satisfactory results, but recurrence is frequent and discouraging. So, surgical treatments are considered in certain cases. The authors report the retrospective analysis of 15 patients treated by nirschl and pettrone procedure. Patients were evaluated with Nirschl and Pettrone assessment method at an average 10.3 months(range, 5 to 32 months0 after surgery. thirteen of 15(87%) patients had more than fair postoperative rating. Two patients had postoperative complications;one with infection and the other with transient mild limitation of elbow motion. No postoperative deterioration of the clinical state was seen. And biopsy specimens of all case showed degenerative changes. Resection of the degenerated site of tendon origin of the humeral epcondyle(The Nirschl and Pettrone procedure) yield satisfactory results in properly selected patients.
Biopsy ; Elbow ; Humans ; Methods ; Recurrence ; Retrospective Studies ; Tendons ; Tennis Elbow ; Tennis

PURPOSE: The aim of this study was to investigate the effects of extracorporeal shock wave therapy (ESWT) an lateral epicondylitis of the elbow. MATERIALS AND METHODS: Twenty-four patients with refractory lateral epicondylitis were treated with shock waves. The patients were evaluated by assessing of pain using visual analog scale (VAS) and a simple elbow test (SET). Overall clinical outcomes were evaluated using Roles and Maudsley scores at 12 months after ESWT. RESULTS: Significant symptom improvement were observed in 20 (83%) patients at the 12 months follow up according to the Roles and Maudesley scores. Average SET and VAS scores were also significantly improved after ESWT (p<0.05). CONCLUSION: This study suggests that shock waves therapy could be considered as an effective and noninvasive treatment modality for refractory lateral epicondylitis of the elbow.
Elbow ; Follow-Up Studies ; Humans ; Shock ; Tennis Elbow* ; Tennis* ; Visual Analog Scale

One hundred and forty eight cases of tennis elbow were treated by conservative managements firstly such as rest, medication, immobilization, physical therapy and/or local steroid injection, from Jan. 1985 to Jun. 1994 at Department of Orthopaedic Surgery, National Medical Center. Among the 148 cases, 16 cases who failed conservative managements, were treated with Nirschl & Pettrone operation. The results were summarized as follows, 1. Among the 148 cases, 110 cases(74%) were female, and 61 cases(41.2%) were in the age group 41 to 50 years old, and mean age was 42.3 years old. 2. Ninty nine cases were housewives and only 15 cases were related to sports. 3. The conservative results of one hundred and sixteen patients were graded excellent and good; and of thirty two patients, fair and failure. 4. The operative results of seven patients were graded excellent; of three, good; of four, fair; and of two, failed. 5. Recurence was developed in 18 cases(12.2%), and we obtained excellent and good result in 17 cases with both conservative and operative treatment. Above results suggest that the term, tennis elbow is a misnomer because it occurs more commonly in non-athletes such as housewives than in tennis players. So it seems to be an occupational disease rather that sports injury. Now, we propose to eliminate of the term of tennis elbow and to substitude with new terminology that describes the true understanding and therapeutic orientation of it.
Athletic Injuries ; Female ; Humans ; Occupational Diseases ; Restraint, Physical ; Sports ; Tennis Elbow ; Tennis