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SHORT-TERM EFFECTIVENESS OF SUTURE ANCHOR AFTER DEBRIDEMENT OF EXTENSOR TENDON INSERTION FOR RECALCITRANT LATERAL EPICONDYLITIS

DENG Yinshuan1,TANG Kanglai1,LI Hui1,ZHANG Jiqiang2,XIE Meiming1,CAO Honghui1,CHEN Yan1,CHEN Lei1,ZHOU Binghua1,TAN Xiaokang1,XU Jianzhong1.1Department of Orthopedics,the Orthopedic Surgery Center of Chinese PLA,Southwest Hospital,the Third Military Medical University,Chongqing,400038,P.R.China;2Department of Neurobiology,College of Basic Medical Sciences,Chongqing Key Laboratory of Neurobiology,the Third Military Medical University.  
Objective To analyze the short-term effectiveness of repairing musculus extensor carpi radialis brevis(ECRB) and extensor digitorum communis(EDC) tendon using suture anchor after debridement of extensor tendon insertion for recalcitrant lateral epicondylitis.Methods Between March 2009 and May 2011,10 patients(10 elbows) with recalcitrant lateral epicondylitis received repair of the ECRB and EDC tendon to the lateral epicondyle using a single suture anchor after debridement of extensor tendon insertion.There were 6 males and 4 females with an average age of 45.4 years(range,36-57 years).The dominant elbow was involved in 8 patients and nondominant elbow in 2 patients;there were 4 manual workers and 6 ordinary workers.The disease duration ranged from 8 to 24 months(mean,12.3 months).All patients had epicondylus lateralis humeri pain,local swelling and tenderness,and positive Mill sign.The average elbow range of motion(ROM) was 11.3°(range,0-30°) in extension and was 132.5°(range,120-145°) in flexion.Preoperative MRI showed external humeral epicondylitis in all patients.Results Primary wound healing was obtained in all patients without complications of infection,leakage of joint fluid,and stiffness of elbow.Ten patients were followed up 4 to 23 months with an average of 12 months(more than 12 months in 7 cases).The time to return to work was(3.75 ± 0.95) months for manual workers and was(2.91 ± 0.20) months for ordinary workers,showing no significant difference(t=1.715,P=0.180).Compared with preoperation,the mean visual analogue scale(VAS) score significantly decreased(P0.05),and Mayo score and the grip strength of dominant and nondominant significantly increased(P0.05),but no significant difference was found when compared with non-surgical side at last follow-up(P0.05).At last follow-up,the average ROM was —1.5°(range,0-—10°) in extension and was 150.5°(range,140-160°) in flexion.Conclusion To suture anchor for repairing the ECRB and EDC after debridement is a satisfactory procedure to treat recalcitrant lateral epicondylitis.It can effectively prevent loss of the forearm extensor strength,relieve the pain,recover the grip strength,and obtain good results.
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