桡尺近侧关节损伤与网球肘的鉴别及手法治疗  

Differentiation diagnosis between proximal radioulnar joints damage and tennis elbow and manipulative treatment

作　　者：范炳华[1] 谢远军[1] 叶金波[2] 

机构地区：[1]浙江中医药大学附属第三医院,浙江杭州310009 [2]玉环县中医院

出　　处：《中国骨伤》2007年第6期397-398,共2页China Journal of Orthopaedics and Traumatology

摘　　要：目的：探讨桡尺近侧关节损伤与网球肘的鉴别,观察手法治疗的疗效。方法：临床收集被诊断为顽固性网球肘疗效不显著患者39例44肘,男18例,女21例;年龄21~59岁,平均41岁。病程5个月~3年,平均11.5个月。双肘发病5例,单肘发病34例;右侧29肘,左侧15肘。按桡尺近侧关节损伤诊断,根据压痛部位的不同分为：肱桡关节型7肘,桡尺近侧关节背侧型25肘,桡尺近侧关节掌侧型12肘。采用分型、定位、定向推拿手法治疗,观察疗效。结果：治疗次数3~10次,平均7.5次。治愈31肘,好转11肘,无效2肘,总有效率95.45%。结论：桡尺近侧关节损伤易被误诊为网球肘,应引起临床注意。分型、定位、定向手法推拿能明显提高疗效。Objective： To study the differentiation diagnosis between proximal radioulnar joints damage and tennis elbow, and to explore therapeutic effects of manipulative method for the treatment of tennis elbow. Methods： Among 39 patients （44 elbows ） diagnosed as intractable tennis elbow, 18 patients were male and 21 patients were female, ranging in age from 21 to 59 years,with an average of 41 years. The course of disease ranged from 5 months to 3 years,with an average of 11.5 months. Five patients had double elbows damaged and 34 patients had single elbow damaged. Twenty-nine damaged elbows occurred in the right and 15 in the left. According to the diagnosis of proximal radioulnar joints damage, the injuries were classified to three typos based on different tenderness ： humeroradial joints type in 7 elbows, dorsal type of proximal radioulnar joint in 25 elbows, and palmar type of proximal radioulnar joint in 12 elbows. All the patients were treated with directional manipulative methods according to different type and position of injuries. Results：The treatment times ranged from 3 to 10（ average 7.5 times）. According to evaluation standard of lateral humeral epicondylitis, the results were excellent in 31 elbows, good in 11 elbows, bad in 2 elbows, the excellent and good rate was 95.45%. Conclusion： The proximal radioulnar joints damage is often misdiagnosed as tennis elbow, which should be paid attention to. The directional manipulative method according to the type and position of injuries is effective to treat proximal radioulnar joints damage.

关 键 词：创伤和损伤 网球肘 诊断 鉴别 骨科手法 

分 类 号：R681.7[医药卫生—骨科学]