U. Erdem IŞIKAN, Sezgin SARBAN, Yavuz KOCABEY

Kronik konservatif tedaviye dirençli lateral epikondilitte açık cerrahi tedavi sonuçları

Amaç: Konservatif tedaviye yanıt vermeyen kronik lateral epikondilitte uyguladığımız açık cerrahi tedavinin klinik ve sübjektif fonksiyonel sonuçları değerlendirildi. Çalışma planı: Lateral epikondilit tanısı ile açık cerrahi girişim uygulanan 11 hasta (7 kadın, 4 erkek; ort. yaş 42; dağılım 29-56) incelendi. Cerrahi tedaviden önce tüm hastalara en az bir yıl süreyle konservatif tedavi uygulandı ve yanıt alınamadı. Cerrahi işlem, ekstansör orijinin gevşetilmesi, dejeneratif dokunun eksizyonu, anterior lateral kondilin dekortikasyonu ya da drillenmesi ve ekstansör tendon onarımını içermekteydi. Hastalar Verhaar ve ark.nın ölçütlerine göre değerlendirildi. Ortalama izlem süresi 29 ay (dağılım 18-45 ay) idi. Sonuçlar: On hastada (%90.9) iyi veya mükemmel, bir hastada (%9.1) orta derecede sonuç elde edildi. Ortalama işgücü kaybı iki aydı. Dokuz hastada ameliyat sonrası üçüncü ayda ağrı tamamen kayboldu. Hiçbir hastada ameliyat sahası ile ilgili sorun olmadı. Sübjektif fonksiyonel değerlendirmede, 10 hasta sonuçtan ileri derecede memnun olduğunu, bir hasta ise kısmen memnun olduğunu belirtti. Çıkarımlar: Konservatif tedaviye yanıt vermeyen kronik lateral epikondilitli olgularda, ekstansör tendonların yapışma yerinden gevşetilmesi ve dejeneratif dokuların eksizyonunu içeren açık cerrahi tedavi, başarı oranı yüksek bir yöntemdir.

Anahtar Kelimeler:

Hareket açıklığı, eklem, Tendon yaralanmaları, Tenisçi dirseği, Dirsek eklemi

The results of open surgical teratment in patients with chronic refractory lateral epicondylitis

Objectives: We evaluated the clinical and subji functional results of open surgical treatment in pa with chronic refractory lateral epicondylitis. Methods: Eleven patients (7 females, 4 males; meant years, range 29 to 56 years) underwent open surgical ment for chronic refractory lateral epicondylitis. A patients had received conservative treatment for at least without favorable response. Surgical procedure inc release of the lateral extensor origin, excision of the dej ative tissue, decortication or drilling of the anterior ] condyle, and repair of the extensor tendons. The results evaluated according to the criteria proposed by Verhaai The mean follow-up was 29 months (range 18 to 45 mo Results: The results were excellent or good in 10 pa (90.9%) and acceptable in one patient (9.1%). The time to return to work was two months. Nine pa were free of pain in the forearm in the postoperative month. No wound-related complications were em tered. On subjective evaluations, 10 patients reporte satisfaction, and one patient reported partial satisfa with the result of the treatment. Conclusion: Open surgical procedure including re of the origins of the common extensor tendons and sion of the degenerative tissue yields favorable resu the treatment of patients with chronic refractory epicondylitis.

Keywords:

Range of Motion, Articular, Tendon Injuries, Tennis Elbow, Elbow Joint,

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