Nirschl and Pettrone described the lesion they found at operation for lateral tennis elbow and reported the results of a specific technique to expose, excise and repair it.
Operative series of 88 elbows in 82 patients, drawn from 1,213 lateral tennis elbow cases seen December 1971 to October 1977.
Methods
Indication
Lateral tennis elbow treated operatively
88 elbows in 82 patients
Approach
ECRL retracted to expose the ECRB origin. Extensor aponeurosis left attached
Diseased ECRB origin excised and lateral condyle decorticated
ECRL‑extensor aponeurosis interface repaired (ECRB not sutured)
Of 88 elbows, 66 were rated excellent, 9 good, 11 fair and 2 failed, and 97.7% had improved over their preoperative state.
Full activity, rigorous sports included, was regained by 85.2% of patients.
Complete pain relief came at a mean of 2.6 months after surgery (range 8 days to 12 months) in elbows rated excellent or good.
Grip strength on dynamometer matched or exceeded the unoperated arm at a mean of 4.2 months (range 1 to 12) in the same elbows.
Of 38 tennis players operated on, 32 returned to regular match play at a mean of 6.1 months (range 3 to 9).
Only a small share of the caseload went to surgery: 88 elbows out of 1,213 lateral tennis elbow cases seen.
Board pearl
Nirschl and Pettrone identified the lesion of operated tennis elbow as angiofibroblastic hyperplasia, an infiltrate of immature fibroblasts and vessels at the ECRB origin.
Nirschl and Pettrone described the lesion they found at operation for lateral tennis elbow and reported the results of a specific technique to expose, excise and repair it.
Operative series of 88 elbows in 82 patients, drawn from 1,213 lateral tennis elbow cases seen December 1971 to October 1977.
Methods
Indication
Lateral tennis elbow treated operatively
88 elbows in 82 patients
Approach
ECRL retracted to expose the ECRB origin. Extensor aponeurosis left attached
Diseased ECRB origin excised and lateral condyle decorticated
ECRL‑extensor aponeurosis interface repaired (ECRB not sutured)
Of 88 elbows, 66 were rated excellent, 9 good, 11 fair and 2 failed, and 97.7% had improved over their preoperative state.
Full activity, rigorous sports included, was regained by 85.2% of patients.
Complete pain relief came at a mean of 2.6 months after surgery (range 8 days to 12 months) in elbows rated excellent or good.
Grip strength on dynamometer matched or exceeded the unoperated arm at a mean of 4.2 months (range 1 to 12) in the same elbows.
Of 38 tennis players operated on, 32 returned to regular match play at a mean of 6.1 months (range 3 to 9).
Only a small share of the caseload went to surgery: 88 elbows out of 1,213 lateral tennis elbow cases seen.
Board pearl
Nirschl and Pettrone identified the lesion of operated tennis elbow as angiofibroblastic hyperplasia, an infiltrate of immature fibroblasts and vessels at the ECRB origin.