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Lateral Epicondylitis Release

PREOPERATIVE DIAGNOSIS: Lateral epicondylitis.

POSTOPERATIVE DIAGNOSIS: Lateral epicondylitis.

OPERATIONS PERFORMED: Lateral release with lengthening of the ECRB tendon.



DESCRIPTION OF PROCEDURE: With the patient under adequate anesthesia, the upper extremity was prepped and draped in a sterile manner. The arm was exsanguinated and the tourniquet elevated to 290 mm/Hg. An incision was made over the lateral aspect of the right elbow anterior to lateral epicondyle and centered on the lateral epicondyle. Blunt dissection exposed the antebrachial fascia. The interval between the extensor carpi radialis longus and anterior edge of the extensor aponeurosis was identified. The antebrachial fascia was then incised and further blunt dissection developed the interval between ECRL and extensor aponeurosis from the lateral epicondyle distal to the joint line. The ECRL was then released by sharp dissection and retracted anterior to expose the origin of the extensor carpi radialis brevis. Medial dissection further delineated the origin of the ECRB. The origin of the ECRB was then further inspected and gross pathological changes of grayish tissue were identified and this friable tissue was then excised. The joint capsule was then incised. The radial capitellar joint was inspected and found to be without pathological changes.

The wound was then copiously irrigated. The joint capsule was closed with interrupted 3-0 Vicryl sutures. The ECRB was then lengthened and then sutured to the undersurface of the ECRL using 3-0 Vicryl sutures. The antebrachial fascia was closed with a running 3-0 Vicryl suture with a Krackow technique. The wound was then infiltrated with 10 cc of .025% Marcaine. The skin was closed in a layered fashion. Sterile dressings were applied. The tourniquet was deflated. The patient was awakened from anesthesia and returned to the recovery room in satisfactory procedure having tolerated the procedure well.

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