[Results of surgical treatment of radio-humeral epicondylopathy].
We examined extent and affection of an assumed neuromuscular transmission disorder by performing a prospective clinical study on 75 patients with therapy-resistant radiohumeral epicondylopathy. Before operation, we electromyographically diagnosed an increased rate of polyphasic potentials of the long wrist extensors as well as a prolonged motor latency of the respective muscles. Corresponding to a hereby implied damage to the distal part of the motor neuron, disordered neuromuscular recruitment combined with a reduced maximum strength and -elasticity could be proven. Both effects were significantly reversible (p < 0.001) through operative intervention. We found a significant correlation (corr < 0.90) between the normalization of the motor latency and increased strength. Subgroups were formed depending on different pre-operative diagnostic efforts and differing redicality regarding the performed soft-tissue operation, thus the clinical validity of the findings diagnosed in the anatomic and neurophysiologic part of the study was additionally examined. It was proven that the failure rate varies between 10% and 30%, depending on the radicality of tenotomy, which could be interpreted as a general indication for complete extensor carpi radialis brevis tendon release. In this connection it is remarkable that the clinical result of an electromyographically localized damage in the area between epicondyle and arcade of Frohse could not be improved through open neurolysis. Dealing with strictures located on the proximal side of the epicondyle on the other hand, this technique seems to play an important role for recurrence prophylaxis.
Albrecht
S
S
Abteilung für Orthopädie des Ev. Waldkrankenhaus Spandau Akademisches Lehrkrankenhaus des Klinikums Rudolf Virchow Medizinische Fakultät der Humboldt Universität Berlin.
Cordis
R
R
Kleihues
H
H
Kahl
C
C
D000328:Adult; D004576:Electromyography; D005260:Female; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009046:Motor Neurons / Q000502:physiology; D009121:Muscle Denervation; D018482:Muscle, Skeletal / Q000294:innervation; D009469:Neuromuscular Junction / Q000503:physiopathology; D011183:Postoperative Complications / Q000503:physiopathology; D011930:Reaction Time / Q000502:physiology; D011999:Recruitment, Neurophysiological / Q000502:physiology; D013716:Tennis Elbow / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome