• 1 第三軍醫(yī)大學(xué)西南醫(yī)院骨科 全軍矯形外科中心（重慶，400038）;;
  • 2第三軍醫(yī)大學(xué)基礎(chǔ)醫(yī)學(xué)院神經(jīng)生物學(xué)教研室 重慶市神經(jīng)生物學(xué)重點(diǎn)實(shí)驗(yàn)室 #現(xiàn)在蘭州軍區(qū)蘭州總醫(yī)院骨科 全軍創(chuàng)傷骨科研究所;

目的 探討伸肌腱止點(diǎn)清理帶線錨釘修復(fù)橈側(cè)腕短伸?。╡xtensor carpi radialis brevis，ECRB）、指伸?。╡xtensor digitorum communis，EDC）治療頑固性網(wǎng)球肘的近期療效。 方法2009年3月－2011年5月，采用伸肌腱止點(diǎn)清理帶線錨釘修復(fù)ECRB及EDC治療單側(cè)頑固性網(wǎng)球肘患者10例。男6例，女4例；年齡36～57歲，平均45.4歲。優(yōu)勢(shì)肘8例，非優(yōu)勢(shì)肘2例；重體力勞動(dòng)者4例，普通工作者6例。病程8～24個(gè)月，平均12.3個(gè)月?；颊呔须殴峭馍削敛刻弁?，局部腫脹壓痛，Mill征（+）。肘關(guān)節(jié)活動(dòng)范圍：伸直0～30°，平均11.3°；屈曲120～145°，平均132.5°。MRI提示均為肱骨外髁炎。 結(jié)果 術(shù)后切口均Ⅰ期愈合，無(wú)感染、關(guān)節(jié)液外漏及肘關(guān)節(jié)強(qiáng)直等并發(fā)癥發(fā)生。10例均獲隨訪，隨訪時(shí)間4～23個(gè)月，平均12個(gè)月；其中7例隨訪12個(gè)月及以上者均未復(fù)發(fā)。重體力勞動(dòng)者術(shù)后（3.75 ± 0.95）個(gè)月恢復(fù)原工作，與普通工作者（2.91 ± 0.20）個(gè)月比較，差異無(wú)統(tǒng)計(jì)學(xué)意義（t=1.715，P=0.180）。術(shù)后1、3個(gè)月及末次隨訪時(shí)疼痛視覺(jué)模擬評(píng)分（VAS）均較術(shù)前顯著下降（P  lt; 0.05），Mayo評(píng)分均較術(shù)前顯著提高（P  lt; 0.05）；優(yōu)勢(shì)側(cè)及非優(yōu)勢(shì)側(cè)握力均較術(shù)前顯著提高（P  lt; 0.05），末次隨訪時(shí)與非手術(shù)側(cè)握力比較差異均無(wú)統(tǒng)計(jì)學(xué)意義（P  gt; 0.05）。末次隨訪時(shí)肘關(guān)節(jié)活動(dòng)范圍：伸直0～—10°，平均—1.5°；屈曲140～160°，平均150.5°。 結(jié)論伸肌腱止點(diǎn)清理帶線錨釘修復(fù)ECRB及EDC治療頑固性網(wǎng)球肘，能有效防止前臂伸肌力量潛在丟失，且創(chuàng)傷小，疼痛緩解顯著，握力恢復(fù)接近正常，近期療效較好。

引用本文： 鄧銀栓,唐康來(lái),李輝,張吉強(qiáng),謝美明,曹洪輝,陳艷,陳磊,周兵華,譚曉康,許建中. 伸肌腱止點(diǎn)清理帶線錨釘修復(fù)治療頑固性網(wǎng)球肘的近期療效. 中國(guó)修復(fù)重建外科雜志, 2013, 27(1): 1-6. doi: 復(fù)制

版權(quán)信息： ?四川大學(xué)華西醫(yī)院華西期刊社《中國(guó)修復(fù)重建外科雜志》版權(quán)所有，未經(jīng)授權(quán)不得轉(zhuǎn)載、改編

1. Behrens SB, Deren ME, Matson AP, et al. A review of modern management of lateral epicondylitis. Phys Sportsmed, 2012, 40(2): 34-40.
2. Kotnis NA, Chiavaras MM, Harish S. Lateral epicondylitis and beyond: imaging of lateral elbow pain with clinical-radiologic correlation. Skeletal Radiol, 2012, 41(4): 369-386.
3. Solheim E, Hegna J, ?yen J. Extensor tendon release in tennis elbow: results and prognostic factors in 80 elbows. Knee Surg Sports Traumatol Arthrosc, 2011, 19(6): 1023-1027.
4. Walz DM, Newman JS, Konin GP, et al. Epicondylitis: pathogenesis, imaging, and treatment. Radiographics, 2010, 30(1): 167-184.
5. Shiri R, Viikari-Juntura E. Lateral and medial epicondylitis: role of occupational factors. Best Pract Res Clin Rheumatol, 2011, 25(1): 43-57.
6. Rhyou IH, Kim KW. Is posterior synovial plica excision necessary for refractory lateral epicondylitis of the elbow? Clin Orthop Relat Res, 2013, 471(1): 284-290.
7. Wolf JM, Mountcastle S, Burks R, et al. Epidemiology of lateral and medial epicondylitis in a military population. Mil Med, 2010, 175(5): 336-339.
8. Coleman B, Quinlan JF, Matheson JA. Surgical treatment for lateral epicondylitis: a long-term follow-up of results. J Shoulder Elbow Surg, 2010, 19(3): 363-367.
9. Pruzansky ME, Gantsoudes GD, Watters N. Late surgical results of reattachment to bone in repair of chronic lateral epicondylitis. Am J Orthop (Belle Mead NJ), 2009, 38(6): 295-299.
10. Karkhanis S, Frost A, Maffulli N. Operative management of tennis elbow: a quantitative review. Br Med Bull, 2008, 88(1): 171-188.
11. Shiri R, Viikari-Juntura E, Varonen H, et al. Prevalence and determinants of lateral and medial epicondylitis: a population study. Am J Epidemiol, 2006, 164(11): 1065-1074.
12. Lee BG, Cho NS, Rhee YG. Modified Mason-Allen suture bridge technique: a new suture bridge technique with improved tissue holding by the modified Mason-Allen stitch. Clin Orthop Surg, 2012, 4(3): 242-245.
13. Fu SC, Rolf C, Cheuk YC, et al. Deciphering the pathogenesis of tendinopathy: a three-stages process. Sports Med Arthrosc Rehabil Ther Technol, 2010, 13(2): 30.
14. 李輝, 唐康來(lái), 鄧銀栓, 等. 外源性前列腺素E2對(duì)兔跟腱膠原含量的影響. 中國(guó)修復(fù)重建外科雜志, 2012, 26(3): 352-358.
15. Kumar S, Stanley D, Burke NG, et al. Tennis elbow. Ann R Coll Surg Engl, 2011, 93(6): 432-436.
16. Bunata RE, Brown DS, Capelo R. Anatomic factors related to the cause of tennis elbow. J Bone Joint Surg (Am), 2007, 89(9): 1955-1963.
17. Thornton SJ, Rogers JR, Prickett WD, et al. Treatment of recalcitrant lateral epicondylitis with suture anchor repair. Am J Sports Med, 2005, 33(10): 1558-1564.
18. Rayan F, Rao VS, Purushothamdas S, et al. Common extensor origin release in recalcitrant lateral epicondylitis-role justified? J Orthop Surg Res, 2010, 5(1): 31.
  1. 1. Behrens SB, Deren ME, Matson AP, et al. A review of modern management of lateral epicondylitis. Phys Sportsmed, 2012, 40(2): 34-40.
  2. 2. Kotnis NA, Chiavaras MM, Harish S. Lateral epicondylitis and beyond: imaging of lateral elbow pain with clinical-radiologic correlation. Skeletal Radiol, 2012, 41(4): 369-386.
  3. 3. Solheim E, Hegna J, ?yen J. Extensor tendon release in tennis elbow: results and prognostic factors in 80 elbows. Knee Surg Sports Traumatol Arthrosc, 2011, 19(6): 1023-1027.
  4. 4. Walz DM, Newman JS, Konin GP, et al. Epicondylitis: pathogenesis, imaging, and treatment. Radiographics, 2010, 30(1): 167-184.
  5. 5. Shiri R, Viikari-Juntura E. Lateral and medial epicondylitis: role of occupational factors. Best Pract Res Clin Rheumatol, 2011, 25(1): 43-57.
  6. 6. Rhyou IH, Kim KW. Is posterior synovial plica excision necessary for refractory lateral epicondylitis of the elbow? Clin Orthop Relat Res, 2013, 471(1): 284-290.
  7. 7. Wolf JM, Mountcastle S, Burks R, et al. Epidemiology of lateral and medial epicondylitis in a military population. Mil Med, 2010, 175(5): 336-339.
  8. 8. Coleman B, Quinlan JF, Matheson JA. Surgical treatment for lateral epicondylitis: a long-term follow-up of results. J Shoulder Elbow Surg, 2010, 19(3): 363-367.
  9. 9. Pruzansky ME, Gantsoudes GD, Watters N. Late surgical results of reattachment to bone in repair of chronic lateral epicondylitis. Am J Orthop (Belle Mead NJ), 2009, 38(6): 295-299.
  10. 10. Karkhanis S, Frost A, Maffulli N. Operative management of tennis elbow: a quantitative review. Br Med Bull, 2008, 88(1): 171-188.
  11. 11. Shiri R, Viikari-Juntura E, Varonen H, et al. Prevalence and determinants of lateral and medial epicondylitis: a population study. Am J Epidemiol, 2006, 164(11): 1065-1074.
  12. 12. Lee BG, Cho NS, Rhee YG. Modified Mason-Allen suture bridge technique: a new suture bridge technique with improved tissue holding by the modified Mason-Allen stitch. Clin Orthop Surg, 2012, 4(3): 242-245.
  13. 13. Fu SC, Rolf C, Cheuk YC, et al. Deciphering the pathogenesis of tendinopathy: a three-stages process. Sports Med Arthrosc Rehabil Ther Technol, 2010, 13(2): 30.
  14. 14. 李輝, 唐康來(lái), 鄧銀栓, 等. 外源性前列腺素E2對(duì)兔跟腱膠原含量的影響. 中國(guó)修復(fù)重建外科雜志, 2012, 26(3): 352-358.
  15. 15. Kumar S, Stanley D, Burke NG, et al. Tennis elbow. Ann R Coll Surg Engl, 2011, 93(6): 432-436.
  16. 16. Bunata RE, Brown DS, Capelo R. Anatomic factors related to the cause of tennis elbow. J Bone Joint Surg (Am), 2007, 89(9): 1955-1963.
  17. 17. Thornton SJ, Rogers JR, Prickett WD, et al. Treatment of recalcitrant lateral epicondylitis with suture anchor repair. Am J Sports Med, 2005, 33(10): 1558-1564.
  18. 18. Rayan F, Rao VS, Purushothamdas S, et al. Common extensor origin release in recalcitrant lateral epicondylitis-role justified? J Orthop Surg Res, 2010, 5(1): 31.