Tennis Elbow: Treatment of Resistant Cases by Denervation

1996 ◽  
Vol 21 (4) ◽  
pp. 523-533 ◽  
Author(s):  
A. WILHELM
Keyword(s):  
Clinical Research ◽  
Surgical Procedure ◽  
Radial Nerve ◽  
Tennis Elbow ◽  
Posterior Interosseous Nerve ◽  
Indirect Decompression ◽  
Nerve Release

Anatomical and clinical research has shown that the entire lateral epicondylar region is innervated only by radial nerve branches. Based on these investigations we have developed a surgical procedure for complete denervation which is indicated only in resistant cases of tennis elbow. Only one nerve pathway calls for careful exposure, otherwise denervation is accomplished blindly by disinsertion of certain muscles. The result of this procedure also depends on simultaneous indirect decompression of the posterior interosseous nerve. Excellent or good results were obtained in 90% on average. Results of denervation did not improve by additional direct radial nerve release.

Resistant Tennis Elbow

1984 ◽  
Vol 9 (1) ◽  
pp. 64-66 ◽  
Author(s):  
G. H. HEYSE-MOORE
Keyword(s):  
Radial Nerve ◽  
Tennis Elbow ◽  
Anatomical Study ◽  
Nerve Entrapment ◽  
Posterior Interosseous Nerve ◽  
Lateral Epicondyle ◽  
Adjacent Structures ◽  
Extensor Carpi Radialis ◽  
Symptoms And Signs ◽  
Results Of Surgery

Fifty cases of resistant tennis elbow were studied, thirty seven of these had been treated by lengthening the tendon of extensor carpi radialis brevis, and thirteen by decompression of the radial tunnel. The two groups were well matched in terms of age, sex and pre-operative symptoms and signs. It was found that the results of surgery were very similar in the two groups and this observation is explained by anatomical study showing that surgical division of the fibrous arch of the superficial leaf of supinator will relieve tension on the lateral epicondyle and its adjacent structures thus allowing relief of symptoms independently of radial or posterior interosseous nerve decompression. This elaborates previously published work showing that there is no clinical or electrical evidence of radial nerve entrapment in resistant tennis elbow.

Radial Tunnel Syndrome

1995 ◽  
Vol 20 (4) ◽  
pp. 454-459 ◽  
Author(s):  
T. LAWRENCE ◽  
P. MOBBS ◽  
Y. FORTEMS ◽  
J. K. STANLEY
Keyword(s):  
Radial Nerve ◽  
Tennis Elbow ◽  
Free Edge ◽  
Wrist Pain ◽  
Duration Of Symptoms ◽  
Supinator Muscle ◽  
Prolonged Duration ◽  
Tunnel Syndrome ◽  
Manual Tasks ◽  
Radial Tunnel Syndrome

Radial tunnel syndrome results from compression of the radial nerve by the free edge of the supinator muscle or closely related structures in the vicinity of the elbow joint. Despite numerous reports on the surgical management of this disorder, it remains largely unrecognized and often neglected. The symptoms of radial tunnel syndrome can resemble those of tennis elbow, chronic wrist pain or tenosynovitis. Reliable objective criteria are not available to differentiate between these pathologies. These difficulties are discussed in relation to 29 patients who underwent 30 primary explorations and proximal decompressions of the radial nerve. Excellent or good results were obtained in 70%, fair results in 13% and poor results in 17% of patients. The results can be satisfactory despite the prolonged duration of symptoms. We believe that a diagnosis of radial tunnel syndrome should always be born in mind when dealing with patients with forearm and wrist pain that has not responded to more conventional treatment. Patients with occupations requiring repetitive manual tasks seem to be particularly at risk of developing radial tunnel syndrome and it is also interesting to note that 66% of patients with on-going medico-legal claims had successful outcomes following surgery.

Compression of the Radial Nerve Caused by an Occult Ganglion

1998 ◽  
Vol 23 (3) ◽  
pp. 420-421 ◽  
Author(s):  
R. STEIGER ◽  
E. VÖGELIN
Keyword(s):  
Radial Nerve ◽  
Nerve Palsy ◽  
Nerve Compression ◽  
Posterior Interosseous Nerve ◽  
Supinator Muscle

We report on three patients with radial nerve compression in the region of the supinator muscle caused by an occult ganglion. After excision of the ganglion and decompression of the posterior interosseous nerve, the nerve palsy resolved completely in all cases.

The Innervation Pattern of the Radial Nerve at the Elbow and in the Forearm

1998 ◽  
Vol 23 (2) ◽  
pp. 167-169 ◽  
Author(s):  
G. BRANOVACKI ◽  
M. HANSON ◽  
R. CASH ◽  
M. GONZALEZ
Keyword(s):  
Radial Nerve ◽  
Sensory Nerve ◽  
Extensor Digitorum ◽  
Sensory Nerves ◽  
Posterior Interosseous Nerve ◽  
Extensor Pollicis Longus ◽  
Abductor Pollicis Longus ◽  
Extensor Carpi Ulnaris ◽  
Wide Variability ◽  
Extensor Carpi Radialis

Sixty paired cadaver forearms were dissected to examine the distribution of the radial nerve branches to the muscles at the elbow and forearm. Emphasis was placed on the innervation of the extensor carpi radialis brevis and the supinator muscles because of discrepancies in the literature concerning these muscles. The most common branching pattern (from proximal to distal) was to brachioradialis, extensor carpi radialis longus, superficial sensory, extensor carpi radialis brevis, supinator, extensor digitorum/extensor carpi ulnaris, extensor digiti minimi, abductor pollicis longus, extensor pollicis brevis, extensor pollicis longus and extensor indicis. The branch to extensor digitorum and extensor carpi ulnaris came off as a common stem often with the branch to extensor digiti minimi. The branch to the ECRB muscle was noted to arise from the posterior interosseous nerve in 45%, superficial sensory nerve in 25% and at the bifurcation of the posterior interosseous and superficial sensory nerves in 30% of specimens. The supinator had an average of 2.3 branches from the posterior interosseous nerve (range 1–6). The branches to the supinator showed a wide variability proximal to and within the supinator.

Nerve Stimulator-guided radial nerve block at elbow: New approach for the treatment of tennis elbow

2019 ◽  
Vol 2 (2) ◽  
pp. 37
Author(s):  
Zoher Naja ◽  
Said Saghieh ◽  
Mohammad Nasreddine ◽  
Rachid Haidar ◽  
AhmadSalah Naja ◽  
...  
Keyword(s):  
Nerve Block ◽  
Radial Nerve ◽  
Tennis Elbow ◽  
Nerve Stimulator ◽  
New Approach

scholarly journals Assessment of the structures at risk during wrist arthroscopy: a cadaveric study and systematic review

2016 ◽  
Vol 41 (8) ◽  
pp. 852-858 ◽  
Author(s):  
G. Shyamalan ◽  
R. W. Jordan ◽  
P. K. Kimani ◽  
P. A. Liverneaux ◽  
C. Mathoulin
Keyword(s):  
Systematic Review ◽  
At Risk ◽  
Ulnar Nerve ◽  
Radial Nerve ◽  
Cadaveric Study ◽  
Wrist Arthroscopy ◽  
Posterior Interosseous Nerve ◽  
Level Of Evidence ◽  
Extensor Tendons ◽  
Dorsal Branch

We assessed the proximity of neurological structures to arthroscopic portals in a cadaveric study and through a systematic review. Arthroscopy was performed on ten cadaveric wrists. Subsequently the specimens were dissected to isolate the superficial branch of the radial nerve, the dorsal branch of the ulnar nerve, the posterior interosseous nerve and the extensor tendons. We measured the distances from the nerves to common portals. For the systematic review Pubmed and EMBASE were searched on the 31 May 2014 for cadaveric studies reporting the proximity of neurological structures to any arthroscopic wrist portal. In the cadaveric study, partial injuries were seen to six extensor tendons and one posterior interosseous nerve; it was assumed this was due to creation of the portals. Seven published studies were included in the systematic review. The dorsal sensory branch of the ulnar nerve was found to be at risk by performing the 6 Ulnar, 6 Radial and ulnar midcarpal portals, the sensory branch of the radial nerve by the 1–2 and 3–4 portals and the posterior interosseous nerve by the 3–4 and 4–5 portals. Level of evidence: V

scholarly journals DIAGNOSIS AND TREATMENT OF POSTERIOR INTEROSSEOUS NERVE ENTRAPMENT: SYSTEMATIC REVIEW

2017 ◽  
Vol 25 (1) ◽  
pp. 52-54 ◽  
Author(s):  
MARCO AURÉLIO DE MORAES ◽  
RUBENS GUILHERME GONÇALVES ◽  
JOÃO BAPTISTA GOMES DOS SANTOS ◽  
JOÃO CARLOS BELLOTI ◽  
FLÁVIO FALOPPA ◽  
...  
Keyword(s):  
Systematic Review ◽  
Radial Nerve ◽  
Case Reports ◽  
Clinical History ◽  
Diagnosis And Treatment ◽  
Posterior Interosseous Nerve ◽  
Level Of Evidence ◽  
Variable Success ◽  
The Subject ◽  
Variable Success Rate

ABSTRACT Compressive syndromes of the radial nerve have different presentations. There is no consensus on diagnostic and therapeutic methods. The aim of this review is to summarize such methods. Eletronic searches related terms, held in databases (1980-2016): Pubmed (via Medline), Lilacs (via Scielo) and Google Scholar. Through pre-defined protocol, we identified relevant studies. We excluded case reports. Aspects of diagnosis and treatment were synthesized for analysis and tables. Quantitative analyzes were followed by their dispersion variables. Fourteen studies were included. All studies were considered as level IV evidence. Most studies consider aspects of clinical history and provocative maneuvers. There is no consensus on the use of electromyography, and methods are heterogeneous. Studies have shown that surgical treatment (muscle release and neurolysis) has variable success rate, ranging from 20 to 96.5%. Some studies applied self reported scores, though the heterogeneity of the population does not allow inferential analyzes on the subject. few complications reported. Most studies consider the diagnosis of compressive radial nerve syndromes essentially clinical. The most common treatment was combined muscle release and neurolysis, with heterogeneous results. There is a need for comparative studies . Level of Evidence III, Systematic Review.

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