The muscles that act to elevate the hand and wrist (dorsiflexion ) are inserted by means of strong tendons into the lining of the bone over the outer aspect of the humerus, which is the main upper arm bone.
The tendons insert into an area over the outer aspect of the humerus in a small localised area.
It is very common to get inflammation of the junction where the tendons blend into the surface of the bone.
This condition is more commonly seen in patients in their 40’s or 50’s but can occur at any age.
Symptoms of a dull ache which is exacerbated by prolonged gripping, such as driving, is common and symptoms can be made worse by gripping handlebars when cycling, for example.
Treatment:
If the tenderness is generalised then physiotherapy, with the help of ultrasound or laser treatment, can be helpful. A brace worn over the outer aspect of the elbow can also be useful. When pain is more localised then an injection of steroid can be curative although somewhat unpredictable. If two or three injections work for only a matter of two or three months at a time then surgical treatment may be required.
Surgical Treatment:
Surgical treatment is invariably successful and can be carried out:
- Arthroscopically. An operating telescope is inserted into the elbow and the tight area of tendons can be divided. There are potentially serious risks from elbow arthroscopy and this treatment is not usually recommended.
- Percutaneous Release: A small incision is made over the area of inflamed tendons and these are divided in the same way as through an elbow arthroscope but approaching the tendon from the outside rather than from the inside. Results of surgery are 80-85 per cent successful. Immobilisation is with a bandage.
- Erasure of the Extensor Origin: I have found this treatment for many years to be almost 100 per cent successful but the disadvantage is that immobilisation of the elbow with a plaster of Paris for six weeks is required. With a very high rate of success from this procedure it often means this is the treatment of choice.
After you have contacted your G.P. a convenient appointment will be made.
I consult at:
- Sarum Road BMI Private Hospital
- Wessex Nuffield Hospital
- London Bridge Hospital
Any operative treatment would usually be done at Sarum Road Hospital. Emergency treatment can be carried out on any day.
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