| 彭旭,银毅,孙官军,李清山,何克,冷雨,叶永杰.改良Nirschl术肌腱止点不同处理方式治疗顽固性网球肘.[J].中南医学科学杂志.,2021,(2):138-143. |
| 改良Nirschl术肌腱止点不同处理方式治疗顽固性网球肘 |
| Modified Nirschl operation with different treatments of tendon attachment for refractory lateral epicondylitis |
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| DOI：10.15972/j.cnki.43-1509/r.2021.02.004 |
| 中文关键词: 网球肘 改良Nirschl术 肌腱止点 [ |
| 英文关键词:lateral epicondylitis modified Nirschl operation tendon attachment |
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| 中文摘要: |
| 目的评价改良Nirschl术肌腱止点不同处理方式治疗顽固性网球肘(RLE)的临床疗效。方法将本院就诊的30例被诊断为顽固性网球肘患者纳入研究,手术方式采用改良Nirschl清理术,手术均由同一医师完成。15例采用改良Nirschl清理术后肌腱止点予以旷置(旷置组),15例采用改良Nirschl术+带线锚钉重建肌腱止点(重建组)。通过对比术前及术后患者疼痛视觉模拟评分(VAS)、梅奥肘关节功能评分系统(MEPS)、患肢握力值变化,改良Nirschl/Pettrone级差评分评价两种不同肌腱止点处理方式治疗顽固性网球肘的临床疗效。结果两组患者术后VAS疼痛评分较术前均显著减少(P＜0.05)；术后MEPS较术前显著增加(P＜0.05),但术后组间比较差异无统计学意义(P＞0.05)。30例患者术前患肢握力均较健侧减少(P＜0.05),旷置组术后各时间节点患肢握力较术前改善但差异无显著性(P＞0.05),重建组术后各时间节点患肢握力明显增加(P＜0.05)。两组患者术后各时间节点改良Nirschl/Pettrone级差评分差异无统计学意义(P＞0.05)。结论改良Nirschl术可快速缓解患者疼痛,改善功能,行肌腱止点重建术后患肢握力恢复更好,适合年轻、术后功能要求较高的患者。 |
| 英文摘要: |
| To evaluate the clinical efficacy of modified Nirschl surgery with different methods of tendon attachment in the treatment of refractory lateral epicondylitis(RLE). MethodsThirty patients who were diagnosed with RLE in our hospital were included in this study. The surgical method was modified Nirschl debridement, and the operations were performed by the same surgeon. 15 cases were treated with modified Nirschl debridement(no-reconstruction group), and 15 cases were treated with modified Nirschl surgery accompanied by tendon attachment reconstruction with anchor(reconstruction group). Visual analogue scale(VAS), Mayo elbow performance score (MEPS), and the change of grip strength of the affected limb, the modified Nirschl/Pettrone score were used to evaluate the clinical efficacy of two different tendon attachment treatment methods for refractory lateral epicondylitis. ResultsThe postoperative VAS scores of the two groups had been significantly reduced compared with preoperation (P＜0.05); The postoperative MEPS had been significantly higher than preoperative(P＜0.05), However, significant differences were not found between groups(P＞0.05). The preoperative grip strength of the affected limb of 30 patients had been significantly reduced compared with the contralateral side(P＜0.05). There was improvement of grip strength in non-reconstruction group compared with preoperative at follow-up(P＞0.05), but the grip strength of reconstruction group had been significantly increased than preoperative at follow-up (P＜0.05). There were low modified Nirschl/Pettrone scores in the two groups(P＞0.05). ConclusionModified Nirschl operation is an effective treatment for refractory lateral epicondylitis, which can quickly relieve pain and improve function. After tendon attachment reconstruction, the grip strength of the affected limb get the better recovery,which is suitable for younger and higher functional requirements patients. |
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