摘要
目的比较切开和关节镜手术治疗顽固性网球肘的临床疗效。方法2006年5月至2008年9月连续收治顽固性网球肘患者26例（28例肘），手术时患者平均年龄45岁（32～62岁），保守治疗时间为23个月（4～60个月）。手术方式以Nirsehl术为原则，按照随机表随机分为切开组（13例13肘）和关节镜组（13例15肘）。采用VAS疼痛评分、Mayo功能评分、肘关节综合评分、重返工作和运动时间、满意度等评价患者术后效果。结果26例患者均获随访，随访时间4～32个月，平均17．4个月。两组术后效果比较，在VAS疼痛评分中的静息和日常活动评分、综合评分、重返工作和运动时间、满意度及术后效果评价等级方面，两组均无显著差异。而在VAS评分的运动评分及Mayo功能评分中，切开组优于关节镜组。切开组满意或部分满意患者100％，关节镜组86．7％。切开组优良率100％，关节镜组93．3％。术后未发现严重并发症。结论切开和关节镜手术均是治疗顽固性网球的有效方法，切开手术在术后恢复运动等肘关节功能方面优于关节镜手术，可能与切开术中有更多伸肌腱裂口被缝合有关。
Objective To compare open and arthroscopic methods for treatment of recalcitrant lateral epicondylitis. Methods A prospective trial of 26 patients （28 elbows） with recalcitrant lateral epicondylitis were treated between May 2006 and September 2008. The mean duration of conservative care was 23. 0 months （4-60 months）. The mean follow-up was 17. 4 months （4-32 months）. The patients were randomized divided into two groups, 13 elbows with an open Nirschl procedure and 15 with an arthroscopic Nirschl procedure. All patients had pre- and post-operative assessment using VAS （visual analog scale） scores, Mayo 12 points elbow scores, time of return to work or sports, satisfaction, and so on. Results There were no significant differences in VAS scores at rest and activities of daily living, time of return to work or sports and satisfaction between the two groups. But there was a statistically significant difference in VAS scores at work and sports and Mayo 12 points elbow scores between the two groups. 100% of the patients had excellent or good results in the open group and 93.3% in arthroscopic group. There were no severe complications in this series. Conclusions Both open and arthroscopic Nirschl procedures are valid and reliable treatments for patients with refractory lateral epicondylitis. The patients in the open group have a better function in the return-to work and sports postoperatively than the arthroscopic group.
出处
《中华外科杂志》
CAS
CSCD
北大核心
2009年第12期888-891,共4页
Chinese Journal of Surgery
