Abstract
The anatomy of the innervation of the lateral humeral epicondyle is described, and related, clinically to “tennis elbow.” Nerve block of the posterior cutaneous nerve of the forearm is described. Confounding clinical decisions related to radial nerve entrapment at the elbow and forearm are discussed. The technical approaches to denervation of the lateral humeral epicondyle are described and illustrated. The results of lateral humeral epicondylar denervation are presented.
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Dellon AL, Kim J, Ducic I. Painful neuroma of the posterior cutaneous nerve of the forearm after surgery for lateral humeral epicondylitis. J Hand Surg Am. 2004;29:387–390, 2004.
Maida E, Chiavaras MM, Jelsing EJ, O’Driscol SW, Pawlina W, Smith J. Sonographic visualization of the posterior cutaneous nerve of the forearm. J Ultrasound Med. 2017;36:1627–37.
Rüdinger N. Die Gelenknerven des menschlichen Körpers. Erlangen: Verlag von Ferdinand Enke; 1857.
Gardner E. The innervation of the elbow joint. Anat Rec. 1947;100:341–6.
Kaplan E. Treatment of tennis elbow (epicondylitis) by denervation. J Bone Joint Surg. 1959;41:147–51.
Wilhelm A. Tennis elbow: treatment of resistant cases by denervation. J Bone Joint Surg. 1996;21(4):523–33.
Berry N, Russel R, Neumeister MW, Dellon AL. Epicondylectomy versus denervation for lateral epicondylitis. Hand. 2011;6:174–8.
Rose N, Forman S, Dellon AL. Denervation of the lateral humeral epicondyle for treatment of chronic lateral humeral epicondylitis. J Hand Surg Am. 2013;38:344–9.
Dellon AL. Partial joint denervation I: wrist, shoulder, elbow. Plast Reconstr Surg. 2009;123:197–207.
Bisset LM, Collins NJ, Offord SS. Immediate effects of 2 types of braces on pain and grip strength in people with lateral epicondylalgia: a randomized controlled trial. J Orthop Sports Phys Ther. 2014;44:120–8.
Scott A, Bell S, Vicenzino B. Chapter 22: Lateral elbow pain. In: Brukner P, Bahr R, Blair S, Cook J, Crossley K, McConnell J, McCrory P, Noakes T, Kahn K, editors. Brukner & Kahn’s clinical sports medicine. 4th ed. New York: McGraw-Hill; 2012. p. 390–400.
McShane JM. Chapter 14: Common extensor tendon, peritendinous injection. In: Malanga G, Mautner KR, editors. Atlas of ultrasound-guided musculoskeletal injections. New York: McGraw-Hill; 2014. p. 57–60.
Seroussi RE, Singh V, Karl HW. Chapter 35:Deep branch of radial nerve entrapment. In: Trescot AM, editor. Peripheral nerve entrapments. Switzerland: Springer; 2016. p. 349–54.
Mi B, Liu G, Zhou W, Lv H, Liu Y, Wu Q, Liu J. Platelet rich plasma versus steroid on lateral epicondylitis: meta-analysis of randomized clinical trials. Phys Sportsmed. 2017;45:97–104.
Spacca G, Necozione S, Cacchio A. Radial shock wave therapy for lateral epicondylitis: a prospective randomised controlled single-blind study. Erus Medicophys. 2005;41:17–25.
Stergioulas A. Effects of low-level laser and plyometric exercises in the treatment of lateral epicondylitis. Photomed Laser Surg. 2007;25:204–13.
Oken O, Kahraman Y, Ayhan F, Canpolat S, Yorgancioglu ZR, Oken OF. The short-term efficacy of laser, brace, and ultrasound treatment in lateral epicondylitis: a prospective, randomized, controlled trial. J Hand Ther. 2008;21:63–8.
Degen RM, Cancienne JM, Camp CL, Altchek DW, Dines JS, Werner BC. Patient-related risk factors for requiring surgical intervention following a failed injection for the treatment of medial and lateral epicondylitis. Phys Sportsmed. 2017;45:433–7.
Bunnell S. Surgery of the hand. Philadelphia: J.B. Lippincott; 1944. p. 673.
Nirschl RP, Pettrone FA. Tennis elbow: the surgical treatment of lateral humeral epicondylitis. J Bone Joint Surg. 1979;61A:832–9.
Almquist EE, Necking L, Bach AL. Epicondylar resection with anconeus muscle transfer for chronic lateral epicondylitis. J Hand Surg. 1998;23a:723–31.
Maida E, Chivaras MM, Jeling EJ, O’Driscoll SW, Pawlina W, Smith J. Sonographic visualization of the posterior cutaneous nerve of the forearm. J Ultrasound Med. 2017;36:1627–37.
Lister GD, Belsole RB, Kleinert HE. Radial tunnel syndrome. J Hand Surg Am. 1979;4:52–9.
Jalovaara P, Lindholm RV. Decompression of the posterior interosseous nerve for tennis elbow. Arch Orthop Trauma Surg. 1989;108:243–5.
Dellon AL, Mackinnon SE. Radial sensory nerve entrapment in the forearm. J Hand Surg. 1986;11A:199–205.
Fujihara Y, Huetteman HE, Chung TT, Shauver MJ, Chung KC. The effect of impactful papers on clinical practice in the US: corticosteroid injection for patients with lateral epicondylitis. Plast Reconstr Surg. 2018;141(5):1183–91.
Meine J, Eicher E. Results of a denervating operation in radial and ulnar humeral epicondylitis. Handchirurgie. 1981;13:254–9.
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Dellon, A.L. (2019). Lateral Elbow (Tennis Elbow) Denervation. In: Joint Denervation. Springer, Cham. https://doi.org/10.1007/978-3-030-05538-7_6
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DOI: https://doi.org/10.1007/978-3-030-05538-7_6
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