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Medial Epicondylitis

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1. In adults with chronic lateral epicondylitis (tennis elbow) are eccentric exercises more effective in reducing pain and improving function than concentric exercises?

Facilitation Group (Cat Group) Critically appraised topic and clinical bottom line Date October 2015: CAT Lead: Liz Hallam & Kay Stevenson Date CAT completed: October 2015 Email: Date CAT to be reviewed: October 2017 References Peterson M Butler S Eriksonm Svardsudd K A randomised controlled trial of eccentric versus concentric graded exercise in chronic tennis elbow 2015 Clinical Rehabilitation 28(9) 862-872 Shiri r and Viikari-Juntura E Lateral and medial epicondylitis; role of occupational factors Best (...) In adults with chronic lateral epicondylitis (tennis elbow) are eccentric exercises more effective in reducing pain and improving function than concentric exercises? Musculoskeletal Research Facilitation Group (Cat Group) Critically appraised topic and clinical bottom line Date October 2015: CAT Lead: Liz Hallam & Kay Stevenson Date CAT completed: October 2015 Email: Date CAT to be reviewed: October 2017 Specific Question: In adults with chronic lateral epicondylitis (tennis elbow

2015 Public Health England

3. Treating tennis elbow (lateral epicondylalgia) with corticosteroid injections are beneficial in the short term but harmful in the long term

that patients to be informed of the long- term negative consequences, to assure that each patient has the opportunity to make an informed decision. 1 Based on the average salary of a family doctor at 57,900 per month Other treatments for tennis elbow Tennis elbow can be treated with physiotherapy and/ or non-selective anti-inflamatory pain medicines. SBU has not evaluated these treatment options. References 1. Shiri R, Viikari-Juntura E. Lateral and medial epicondylitis: Role of occupational factors. Best (...) Treating tennis elbow (lateral epicondylalgia) with corticosteroid injections are beneficial in the short term but harmful in the long term 1 sbu – swedish council on health technology assessment What is tennis elbow? Tendon pain is referred to as tendinopathy when the pain is associated with a tendon, or enthesopathy when the pain is associated with the areas where liga- ments or tendons are attached to the bone. Tendons and their associated tissues can become painful and swollen in response

2014 Swedish Council on Technology Assessement

4. Open Reduction Internal Fixation of a Medial Epicondyle Avulsion Fracture With Incarcerated Fragment. (Abstract)

Open Reduction Internal Fixation of a Medial Epicondyle Avulsion Fracture With Incarcerated Fragment. The purpose of this video is to present a technique for open reduction and internal fixation of a displaced unstable medial epicondyle avulsion fracture.A 13-year-old boy presented 2 days after injury at our institution after sustaining a medial epicondyle avulsion fracture with incarcerated fragment and posterolateral dislocation of the elbow after a fall off a fence. He described paresthesia (...) in the ulnar nerve distribution and demonstrated slight weakness to intrinsic hand strength on examination. He was urgently reduced under sedation in the emergency department using the Roberts maneuver, a technique consisting of a valgus stress with forearm supination with finger and wrist extension that uses muscle forces to extract the fragment. Successful reduction of the ulna-humeral joint and extraction of the incarcerated medial epicondyle was demonstrated on CT. The patient was then taken

2019 Journal of Orthopaedic Trauma

5. The medial epicondyle of the distal femur is the optimal location for MRI measurement of semitendinosus and gracilis tendon cross-sectional area. (Abstract)

The medial epicondyle of the distal femur is the optimal location for MRI measurement of semitendinosus and gracilis tendon cross-sectional area. Graft diameter ≥ 8 mm reduces the risk of failure after anterior cruciate ligament reconstruction (ALCR) with hamstring tendon autograft. Pre-operative measurement of gracilis (GT) and semitendinosus (ST) cross-sectional area using MRI has been utilized but the optimal location for measurement is unknown. The main purpose of this study was to examine (...) the cross-sectional areas of GT + ST at different locations and develop a model to predict whether a doubled hamstring graft of GT + ST will be of sufficient cross-sectional area for ACLR.A retrospective review was performed of 154 patients who underwent primary ACLR using doubled hamstring autograft. Cross-sectional area measurements of GT + ST on pre-operative MRI axial images were made at three locations: medial epicondyle (ME), tibiofemoral joint line (TJL), and tibial physeal scar (TPS

2019 Knee Surgery, Sports Traumatology, Arthroscopy

6. Platelet-rich plasma versus Tenex in the treatment of medial and lateral epicondylitis. Full Text available with Trip Pro

Platelet-rich plasma versus Tenex in the treatment of medial and lateral epicondylitis. Medial epicondylitis and lateral epicondylitis are among the most common elbow pathologies affecting people aged between 40 and 50 years. Although epicondylitis is often a self-limiting condition that improves with conservative treatment, the condition can be difficult to eradicate. The purpose of this study was to compare the effectiveness of platelet-rich plasma (PRP) injections and ultrasound-guided (...) percutaneous tenotomy (Tenex) for the treatment of medial or lateral epicondylitis. Our hypothesis was that the Tenex procedure would not be inferior to PRP injections in the treatment of medial or lateral epicondylitis.In this retrospective review, 62 of 75 patients were available for contact via phone and e-mail to complete post-procedure patient-reported outcome surveys. Subjective assessment of pain and function included a visual analog scale for pain; the Quick Disabilities of the Arm, Shoulder

2019 Journal of Shoulder and Elbow Surgery

7. Tennis elbow

Tennis elbow Tennis elbow - NICE CKS Share Tennis elbow: Summary Tennis elbow or lateral epicondylitis describes a tendinosis (chronic symptomatic degeneration of the tendon) that affects the common attachment of the tendons of the extensor muscles of the forearm to the lateral epicondyle of the humerus. It is characterized by pain affecting the region of the lateral epicondyle with radiation down the extensor aspect of the forearm. The person may describe difficulty with raising a cup, shaking (...) extensor origin, and peri-tendinitis of the elbow. Tennis elbow usually occurs after minor or unrecognized trauma of the forearm extensor muscles. Repetitive overuse causes micro-tears near the origin of the common extensor tendon at the lateral epicondyle of the humerus, which initiates a degenerative process. Women and men are affected equally, and peak incidence occurs between 35–54 years of age. Tennis elbow is generally a self-limiting condition, and spontaneously improves in about 80–90

2017 NICE Clinical Knowledge Summaries

8. Ultrasonography has high positive predictive value for medial epicondyle lesions among adolescent baseball players. (Abstract)

Ultrasonography has high positive predictive value for medial epicondyle lesions among adolescent baseball players. Only few studies have investigated medial epicondyle (MEC) lesions, particularly in the 12-18 age group. To the best of our knowledge, no study has compared ultrasonography (US), radiography and magnetic resonance imaging (MRI) in detecting MEC lesions. The aims of this study were to examine the value of US for detecting MEC lesions and to investigate correlations among diagnostic (...) value (PPV) of 88% according to MRI findings. The MEC lesions were primarily comprised of unfused ossicles and bony fragmentation. Other diagnoses, including UCL strain and medial epicondylitis, were also found by MRI in players with abnormal US screening results. The pROM of shoulder external rotation (ER) of the throwing hand was significantly reduced in players with MEC lesions (p = 0.006).Bony cortical discontinuity or fragmentation over the MEC warrants further research, and US provides good

2018 Knee Surgery, Sports Traumatology, Arthroscopy

9. Locating the ulnar nerve during elbow arthroscopy using palpation is only accurate proximal to the medial epicondyle. Full Text available with Trip Pro

Locating the ulnar nerve during elbow arthroscopy using palpation is only accurate proximal to the medial epicondyle. Knowledge of ulnar nerve position is of utmost importance to avoid iatrogenic injury in elbow arthroscopy. The aim of this study was to determine how accurate surgeons are in locating the ulnar nerve after fluid extravasation has already occurred, and basing their localization solely on palpation of anatomical landmarks.Seven cadaveric elbows were used and seven experienced (...) surgeons in elbow arthroscopy participated. An arthroscopic setting was simulated and fluids were pumped into the joint from the posterior compartment for 15 min. For each cadaveric elbow, one surgeon was asked to locate the ulnar nerve solely by palpation of the anatomical landmarks, and subsequently pin the ulnar nerve at two positions: within 5 cm proximal and another within 5 cm distal of a line connecting the medial epicondyle and the tip of the olecranon. Subsequently, the elbows were dissected

2018 Knee Surgery, Sports Traumatology, Arthroscopy

10. The Effectiveness of Medial Femoral Epicondyle Up-Sliding Osteotomy to Correct Severe Valgus Deformity in Primary Total Knee Arthroplasty. (Abstract)

The Effectiveness of Medial Femoral Epicondyle Up-Sliding Osteotomy to Correct Severe Valgus Deformity in Primary Total Knee Arthroplasty. While many surgical techniques can achieve neutral limb alignment and soft tissue balance in severe valgus deformity during total knee arthroplasty (TKA), few published reports concern medial femoral epicondyle up-sliding osteotomy.A prospective investigation was conducted of patients with severe valgus deformities who underwent medial femoral epicondyle up (...) -sliding osteotomy. Clinical measurements, radiological evaluation, and complication data were recorded.Using posterior-stabilized prostheses, 26 patients underwent 28 TKAs performed by the same surgeon using medial femoral epicondyle up-sliding osteotomy to balance the soft tissue. On average, the follow-up was 54 ± 18 months, and the patient age was 63 ± 11 years. All knees were type II according to Krackow's classification. Varus-valgus knee motion was prohibited with the protection of long-leg knee

2018 Journal of Arthroplasty

11. Medial femoral epicondyle upsliding osteotomy with posterior stabilized arthroplasty provided good clinical outcomes such as constrained arthroplasty in primary total knee arthroplasty with severe valgus deformity. (Abstract)

Medial femoral epicondyle upsliding osteotomy with posterior stabilized arthroplasty provided good clinical outcomes such as constrained arthroplasty in primary total knee arthroplasty with severe valgus deformity. A modified technique referred to as a medial femoral epicondyle upsliding osteotomy was proposed to address severe valgus deformity with unconstrained posterior stabilized (PS) arthroplasty. The study compared the effectiveness of the technique and PS arthroplasty with constrained (...) . For group B, the HKA, FTA and VA were restored to (181.5 ± 2.3)°, (172.5 ± 2.3)° and (7.5 ± 2.3)°, respectively. Only two patients from group A demonstrated mild medial laxity in their knees, and the remaining patients from both groups were stable medially and laterally. However, the total hospitalization expenses and material expenses of group A were less than those of group B because of the more expensive constrained prosthesis and stems. No late-onset loosening or recurrent valgus deformity

2018 Knee Surgery, Sports Traumatology, Arthroscopy Controlled trial quality: uncertain

12. Paediatric medial humeral epicondyle fracture management: 2019 approach. (Abstract)

epicondylar fractures of the elbow remains the domain of expert opinion and subject to great variance. Anatomical, biomechanical and computer simulation models suggest great importance should be given to the medial epicondyle and the structures, which insert onto it. However, this does not correlate with outcomes as reported by patients, parents and surgeons.The question of which paediatric medial humeral epicondylar fractures benefit from operative fixation remains unanswered. A large randomized (...) Paediatric medial humeral epicondyle fracture management: 2019 approach. The management of displaced medial humeral epicondyle fractures in children remains controversial. The indications for surgery, the ideal surgical strategy and the implications of a painful nonunion remain unclear.This article describes the state of the evidence and the art in the management of medial humeral epicondyle fractures concentrating on recent research and current opinion. Treatment of paediatric medial

2018 Current Opinion in Pediatrics

13. Intra-Articular Entrapment of the Medial Epicondyle following a Traumatic Fracture Dislocation of the Elbow in an Adult Full Text available with Trip Pro

Intra-Articular Entrapment of the Medial Epicondyle following a Traumatic Fracture Dislocation of the Elbow in an Adult Medial epicondyle entrapment after an acute fracture dislocation of the elbow is a common finding in the pediatric population, but a rare finding in adults. We present a case of an adult patient diagnosed with a traumatic fracture dislocation of the elbow joint with intra-articular entrapment of the medial epicondyle. After initial evaluation, closed reduction was done

2018 Case reports in orthopedics

14. Epicondylitis

. http://www.ncbi.nlm.nih.gov/pubmed/1423702?tool=bestpractice.com Both lateral epicondylitis (commonly known as tennis elbow) and medial epicondylitis (commonly known as golfer's elbow) are characterised by elbow pain during or following elbow flexion and extension. A combination of poor mechanics, microtears in areas of hypoperfusion, and a delayed healing response contribute to the pathophysiology of the condition. Milz S, Tischer T, Buettner A, et al. Molecular composition and pathology (...) to the lateral epicondyle. They report pain during resisted wrist and digit extension, and during passive wrist flexion with the elbow extended. People with medial epicondylitis have tenderness along the medial elbow, approximately 5 mm distal and anterior to the medial epicondyle. Pain is exacerbated with resisted forearm pronation and resisted wrist flexion. Most patients will have complete resolution of symptoms with arm rest and non-steroidal anti-inflammatory drug (NSAID) therapy. Patients

2018 BMJ Best Practice

15. Retraction: Radiological and Functional Outcome of Medial Epicondyle Fracture Treated Surgically in Children and Adolescents: A Retrospective Study Full Text available with Trip Pro

Retraction: Radiological and Functional Outcome of Medial Epicondyle Fracture Treated Surgically in Children and Adolescents: A Retrospective Study [This retracts the article DOI: 10.7759/cureus.953.].

2017 Cureus

16. Arthroscopic surgical treatment of medial epicondylitis. (Abstract)

and 1 (14%) with moderate pain; and 78 on the Short Form 36 Health Survey. No significant complications were observed when the procedure was performed via arthroscopy.Arthroscopic surgical treatment for medial epicondylitis of the elbow exhibits good outcomes and is safe and effective.Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved. (...) Arthroscopic surgical treatment of medial epicondylitis. The study purpose was to evaluate the outcomes of patients who received arthroscopic surgical treatment for medial epicondylitis refractory to conservative treatment.This was a retrospective study of 7 patients who underwent arthroscopic surgical débridement of the common flexor tendon for treatment of medial epicondylitis refractory to conservative treatment. The patients were assessed using the Disabilities of the Arm, Shoulder and Hand

2017 Journal of Shoulder and Elbow Surgery

17. Radiological analysis of the medial epicondyle in the adolescent throwing athlete Full Text available with Trip Pro

Radiological analysis of the medial epicondyle in the adolescent throwing athlete Injuries to the medial structures of the elbow due to overhead throwing games are well documented. However, variations of medial epicondyles are not well described, especially in athletes with fused medial epicondyles. In this study, we evaluated variations in the medial epicondyle of baseball players who were aged 15-17 years and had fused epicondyles.In this cross-sectional observational study, 155 skeletally (...) mature baseball players with unilateral medial elbow pain and 310 elbow radiographs were reviewed by two independent reviewers. The medial epicondyles were categorised into three groups: normal, elongated or separated.Among the 155 patients, 65 (41.9%) had normal epicondyles, 41 (26.5%) had elongated epicondyles and 49 (31.6%) had separated epicondyles. The medial epicondyle was larger on the dominant arm for 125 (80.6%) patients; the mean surface area on the dominant arm was 222.50 ± 45.77 mm2

2017 Singapore medical journal

18. Surgical management of medial humeral epicondylitis, cubital synovial osteochondromatosis and humeroradial subluxation in a cat Full Text available with Trip Pro

Surgical management of medial humeral epicondylitis, cubital synovial osteochondromatosis and humeroradial subluxation in a cat A 13-year-old domestic shorthair cat presented for evaluation of pain and difficulty ambulating. Orthopedic examination and CT facilitated a diagnosis of bilateral elbow synovial osteochondromatosis with medial humeral epicondylitis and concurrent osteoarthritis. Right humeroradial subluxation was evident on CT images, but no instability was evident preoperatively (...) of elbow stability and substantial improvement in mobility and comfort.While humeroradial subluxation has been reported in association with medial humeral epicondylitis on post-mortem examination, associated clinically significant instability has not been documented previously. Surgeons should be aware of the potential for this complication and check elbow stability following surgery. Despite this complication, a favorable medium-term outcome was achieved for this cat.

2017 JFMS Open Reports

19. Bare medial epicondyle physeal fracture of the humerus: A case report Full Text available with Trip Pro

pronation, range of motion and valgus stability of the left elbow had recovered. One year after the injury, radiographs showed atrophy and sclerosis of the medial epicondylar apophysis. In this type of injury, revascularization of medial epicondyle fracture is not essential for recovery of elbow function when reattachment of the medial collateral ligament and flexor-pronator muscle origin to the distal medial humerus successfully restores stability of the elbow joint. (...) Bare medial epicondyle physeal fracture of the humerus: A case report We identified an unusual case of the medial epiondyle physeal fracture, which has been caused by a direct blow, accompanied with complete stripping of soft tissue. Surgery was performed for open reduction and internal fixation of the medial epicondyle and reattachment of the anterior oblique bundle of medial collateral ligament and flexor muscle origin. Six months after the surgery, strength of wrist flexion and forearm

2017 Journal of clinical orthopaedics and trauma

20. Intra-articular Entrapment of Medial Epicondyle Fracture Fragment in Elbow Joint Dislocation Causing Ulnar Neuropraxia: A Case Report Full Text available with Trip Pro

Intra-articular Entrapment of Medial Epicondyle Fracture Fragment in Elbow Joint Dislocation Causing Ulnar Neuropraxia: A Case Report Traumatic elbow dislocations in children are rare but most of them are complex dislocations, and in such dislocations, medial humerus epicondyle fractureis the most common associated injury. Fracture incarceration in the elbow joint occurs in 5-18% of medial humerus epicondyle fractures but ulnar neuropraxia is very rare. Open reduction internal fixation (...) of a 13-year old boy, who presented with right elbow dislocation and intra-articular entrapment of medial humerus epicondyle fracture fragment, complicated with sensory ulnar neuropraxia, following a fall onto his right outstretched hand in a motor vehicle accident. The elbow joint was reduced using close manipulative reduction but the fracture fragment remained entrapped post-reduction. The patient then underwent open reduction and screw fixation of the medial humerus epicondyle fracture without

2017 Malaysian orthopaedic journal

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