Abstract: Introduction: When the non-operative treatment of tennis elbow fails to improve the symptoms a surgical procedure can be performed. Many different techniques are available. Local release of the common extensor origin was first presented by Loose at a meeting in 1962. Despite the simplicity of the operation and its effectiveness in relieving pain with minimal scarring this procedure is still not widely accepted. This study presents the long-term results of tennis elbow release in patients when conservative measures including local steroid injections have failed to relieve the symptoms.
Patients and Methods: under aseptic conditions lateral epicondyle is marked and 2% lignocaine with adrenaline is infiltrated under the skin on either side of epicondyle. Periosteum is also infiltrated deep.4 cm incision is made on lateral epicondyle with elbow flexed and supine position. Fascia over the common extensors is opened and retracted. Subperiosteal elevation of common extensors is done on both anterior and posterior aspect of lateral epicondyle. Lateral epicondyle is decorticated till bleeding occurs. Debridement of the deceased extensors done. Wash given. Fascial closure done followed by skin closure. Compression bandage applied for 2 days. Sutures removed after 10 days. Movements encouraged. The patients were assessed post operatively by using DASH (disabilities of arm, shoulder and hand) score and Oxford elbow scores. The mean follows up period was 24 months.
Results: Twenty-one patients returned the DASH and Oxford elbow questionnaires. Four patients were lost in the follow up. The post operative outcome was good to excellent in most patients. Eighty seven percent of patients had complete pain relief. The mean post-op DASH score was 8.47 (range 0 to 42.9) and the mean Oxford elbow score was 42.8 (range 16 to 48). There were no complications reported. All the patients returned to their normal jobs, hobbies such as gardening, horse riding and playing musical instruments.
Conclusion: In our experience local release of the epicondylar muscles for humeral epicondylitis has a high rate of success, is relatively simple to perform, is done as a day case procedure and has been without complications release is a viable treatment option after failed conservative management of tennis elbow.
