封闭与微创手术治疗网球肘的疗效观察

目的:比较封闭与微创手术治疗网球肘的临床效果,探讨较好的治疗方法。方法:封闭组54例,其中男18例,女36例;年龄24~68岁,平均41岁;采用2%利多卡因2~3 ml 强的松龙25 mg在肘外侧痛点处封闭治疗(随访36例)。手术组36例,男14例,女22例;年龄28~62岁,平均39岁;采用局部2%利多卡因麻醉,在痛点处2 cm纵行切口,将伸肌总腱起点附着处半环形部分切断并向远段剥离,局部微血管神经微束切断并结扎(随访31例)。术后按Verhaar标准进行3、6、12个月随访。结果:封闭组3个月时优31例,良2例,可3例,差0例,优良率为91%;6个月时优23例,良4例,可7例,差2例,优良率为75%;12个月时优3例,良2例,可5例,差26例,优良率为14%。手术组在3个月时优27例,良3例,可1例,差0例,优良率为96%;6个月时优29例,良1例,可1例,差0例,优良率为96%;12个月时优25例,良3例,可2例,差1例,优良率为90%。结论:封闭治疗在短期内有较好的效果,微创手术在远近期的疗效都比较理想。

Comparison of block therapy and microtrauma surgery for the treatment of tennis elbow

Objective: To compare the therapeutic effects of local block and micro-trauma surgery for the treatment of tennis elbow,so as to explore the best herapy method.Methods: In lock block group,54 patients(18 male,36 female,ranging in age from 24 to 68 years,with an average of 41 years,36 patients were followed up)were treated with lock block method in the point of external humeral condyle using 2% lidocaine 2ml added up hydroprednisone 25mg.In surgical group,36 patients(14 male,22 female,ranging in age from 28 to 62 years,with an average of 39 years,31 patients were followed up)were treated with semiperitomy at the point of attachment of radial extensor muscle of wrist,which was stripped into the distal portion,as well as cutting and deligation of nerve-tract around lateral humeral condyle.All the patients were followed at 3rd,6th,12th months,and the therapeutic effects were evaluated according to Verhaar standard.Results: In blocking group,an excellent result was obtained in 31 patients,good in 2,fair in 3 and bad in 0,the excellent and good rate was 91% at the 3rd month;and at the 6th month the results were 23,4,7,2,75% respectively;at 12th month were 3,2,5,26,14% respectively.In micro-trauma surgery group,an excellent result was obtained in 27 patients,good in 3,fair in 1 and bad in 0,the excellent and good rate was 96% at the 3rd month;and at the 6th month the results were 29,1,1,0,96% respectively;at 12th month were 25,3,2,1,90% respectively.Conclusion: The local block treatment for tennis elbow is very effective in short time.However,micro-trauma surgery is an ideal method in treating tennis elbow no matter in short term or long term.