[Results of a denervating operation in radial and ulnar humeral epicondylitis]

The treatment of lateral epicondylitis is first of all conservative, and only resistant cases need operative care. The authors performed denervation after the technique of Wilhelm with a slight modification on 63 elbows in 55 patients. The results at follow-up were excellent in 47 elbows and good in 11 (=92%), fair in three and failed in one. According to the anatomical model it is suggested that this procedure permits not only a selective neurotomy of the nerve supply to the lateral epicondyle, but also release of the extensor muscles at their attachment on the epicondyle and on the orbicular ligament; it even seems that it favours indirectly a decompression of the radial nerve in the middle and distal part of the radial tunnel. According to these observations, the operation of denervation satisfies the various etiopathogencial hypotheses concerning tennis elbow, whether it may be due to an insertion tendintis, to the presence of granulomatous tissue in the subtendinous space, to a vertebrogenic irritation syndrome, or to an entrapment neuropathy of the radial nerve. The same considerations can be extended to medial epicondylitis, employed in six cases of the present series; all of them were improved after the operation.