The Fascial Elevation and Tendon Origin Resection Technique for the Treatment of Chronic Recalcitrant Medial Epicondylitis.
BACKGROUND
Medial epicondylitis is a tendinopathy of the common flexor-pronator origin, and surgical treatment is required when this condition fails to respond to nonoperative methods. This study details the development of a new technique, termed fascial elevation and tendon origin resection (FETOR), which facilitates the complete visualization and resection of the CFPO with limited soft tissue dissection.


OBJECTIVE
To evaluate the outcomes of FETOR for the treatment of chronic recalcitrant medial epicondylitis.


METHODS
Case series; Level of evidence, 4.


METHODS
The electronic medical records of patients who underwent FETOR from January 2008 to July 2011 were retrospectively reviewed. Outcome assessments included the visual analog scale (VAS) for average pain, pain at rest, and pain experienced during hard work or heavy lifting; the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire; and pain-free grip strength. Preoperative and postoperative data were compared.


RESULTS
A total of 22 elbows in 20 patients with a mean age of 48.8 years (range, 29-58 years) were included. At a mean follow-up of 35.6 months (range, 16-77 months), the VAS score decreased by 93% for average pain, 94% for pain at rest, and 83% for pain during hard work or heavy lifting (P < .001). The patients' perception of arm function as assessed using the DASH recovered to the level of the healthy population (from a mean of 51.6 ± 18.0 to 8.0 ± 11.1; P < .001). The mean pain-free grip strength improved significantly from 53.7% ± 30.3% to 97.3% ± 19.8% of the uninvolved arm (P < .001). Eighteen (90%) patients were satisfied with the surgical outcomes, while 2 patients changed their jobs because of decreased elbow function. No major complications occurred.


CONCLUSIONS
The FETOR technique is an effective and safe method for the treatment of chronic recalcitrant medial epicondylitis.
Department of Orthopedic Surgery, Hallym University Sacred Heart Hospital, Anyang, South Korea.
Bong Cheol
BC
Kwon
Department of Orthopedic Surgery, Hallym University Sacred Heart Hospital, Anyang, South Korea.
Yong Shin
YS
Kwon
Department of Orthopedic Surgery, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon, South Korea grant903@gmail.com.
Kee Jeong
KJ
Bae
D000328:Adult; D004551:Elbow Joint / Q000503:physiopathology* / Q000601:surgery; D000071938:Fasciotomy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods; D010147:Pain Measurement; D011795:Surveys and Questionnaires; D013710:Tendons / Q000601:surgery*; D013716:Tennis Elbow / Q000503:physiopathology* / Q000601:surgery*
elbow; medial epicondylitis; surgery; tendinopathy