肘关节镜桡侧腕短伸肌腱松解联合关节清理术治疗顽固性网球肘  

Elbow arthroscopic extensor carpi radialis brevis release combined with joint debridement in the treatment of refractory tennis elbow

作　　者：白云鹏 孙卫兵 王苗 丁浩亮 孙健[1] Yunpeng;Sun Weibing;Wang Miao;Ding Haoliang;Sun Jian(Department of Orthopaedics,Jiading Branch of Shanghai General Hospital,Shanghai Jiaotong University School of Medicine,Jiading District Jiangqiao Hospital,Shanghai 201803,China)

机构地区：[1]上海市第一人民医院嘉定医院/上海市嘉定区江桥医院骨科,201803

出　　处：《中华肩肘外科电子杂志》2024年第2期135-139,共5页Chinese Journal of Shoulder and Elbow(Electronic Edition)

摘　　要：目的探讨肘关节镜桡侧腕短伸肌腱(extensor carpi radialis brevis,ECRB)松解联合关节清理术治疗顽固性网球肘的临床疗效。方法回顾性分析2021年1月至2022年12月间本院收治的采用肘关节镜治疗的网球肘病例资料,其中男8例、女10例;年龄29~58岁,平均42.4岁。均采用肘关节镜下ECRB肱骨附着点松解,同时行肘关节清理术。通过对比术前和术后4周、3个月、6个月及末次随访时Mayo肘关节功能评分(Mayo elbow performance score,MEPS)、视觉模拟评分(visual analogue scale,VAS),结合患者满意度,评价临床疗效。结果18例患者均获得随访6~24个月,平均12.5个月。未出现伤口感染、神经血管损伤、肘关节不稳等并发症。术后4周、3个月和6个月及末次随访时MEPS评分及VAS评分较术前均有显著改善,差异有统计学意义(P<0.05),术后3个月、6个月及末次随访时MEPS评分及VAS评分与术后4周相比差异无统计学意义(P>0.05)。15例非常满意,3例满意,满意率100%。结论肘关节镜下ECRB松解联合关节清理术可有效治疗顽固性网球肘,手术创伤小,术后功能恢复快,是一种有效、可靠的手术方法。Background Tennis elbow,also known as lateral epicondylitis,is one of the most common causes of elbow joint pain.When conservative treatment fails to alleviate symptoms for more than six months,it is referred to as refractory tennis elbow,necessitating surgical intervention.Surgical options commonly include open surgery,percutaneous methods,and arthroscopic procedures.Open surgery involves more substantial trauma,while percutaneous techniques may affect postoperative outcomes due to difficulties in precise localization.Arthroscopic extensor carpi radialis brevis(ECRB)release,on the other hand,is gaining favor among surgeons due to its minimal invasiveness,clear intraoperative visualization,precise targeting,and rapid postoperative recovery.However,due to the prolonged learning curve associated with elbow arthroscopy,relatively few institutions in China are performing this procedure,resulting in limited literature on the subject.Objective To investigate the clinical effect of extensor carpi radialis brevis(ECRB)myotendolysis combined with joint debrideation by elbow arthroscopy in treating intractable tennis elbow.Methods A retrospective analysis of 18 cases treated with elbow arthroscopy for tennis elbow were conducted in our hospital between January 2021 and December 2022.Eight males and ten females were included,with ages ranging from 29 to 58 years and an average age of 42.4 years.All underwent arthroscopic release of the extensor carpi radialis brevis tendon at its attachment on the humerus,along with debridement of the elbow joint.Clinical efficacy was evaluated by comparing the Mayo elbow performance score(MEPS),and visual analogue scale(VAS)scores preoperatively and at 4 weeks,3 months,6 months,and final follow-up,combined with patient satisfaction.Results All 18 cases were followed up for 6 to 24 months,with an average of 12.5 months.No complications such as wound infection,nerve or vascular damage,or elbow joint instability were observed postoperatively.The MEPS and VAS scores showed significant improvem

关 键 词：肘关节 网球肘 关节镜 

分 类 号：R687.4[医药卫生—骨科学]