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Tennis Elbow, A Condition Affecting More than Those on the Court

Posted on January 22nd, 2009

Tennis elbow, or lateral epicondylitis, is one of the most common upper extremity conditions seen in orthopedics today. It is a common tendinopathy classified as an overuse or overstress condition and can be the result of a repetitive activity fatiguing the hand, wrist, forearm or elbow.

The fatigue and stress creates an inflammation that grows increasingly worse over time.

There are over nine million reported cases of tennis elbow in the United States alone every year, though most of those diagnosed with Tennis Elbow have never played tennis. While tennis is the sport for which the condition is named, affecting approximately five in 10 recreational and professional tennis players, the most prominent profile of a tennis elbow patient is the average man and woman between the ages of 40 and 60 – performing everyday activities. A smaller percentage of those diagnosed with tennis elbow, approximately 10 to 20 percent, are those sustaining severe injury resulting from a fall or direct hit to the area.

Tennis elbow actually causes the tendons around the elbow to become inflamed and results in pain at the outside, or lateral side, of the elbow – as opposed to the inside, or medial side, of the elbow associated with a condition known as Golfer’s Elbow, or medial epicondylitis.

Tennis elbow often occurs in the dominant arm. If left untreated, the affected tendon can tear and cause scar tissue to develop. Those suffering from the condition may experience moderate to debilitating pain as the tendon becomes increasingly weaker over time.

Some of the common symptoms of tennis elbow include:
• Pain along the outside of the elbow of the dominant arm – radiating or traveling into the forearm and possibly the hand.
• Pain and subsequent weakness with reaching or grabbing activities.

New Dupuytren Procedure Comes to the United States

Posted on January 18th, 2009

Proves promising to Dupuytren Patients – European procedure providing hope to Dupuytren Contracture patients reluctant to undergo surgery.

In our last blog of the Dupuytren Series we discussed the effects of Dupuytren’s Disease and who is most often impacted. This blog is dedicated to the discussion of the promising new treatment for those who suffer from severe Dupuytren contractures that either continue to reoccur following conservative treatment or exceed acceptable degrees of contraction and severely limit hand function.

Traditionally, open surgery to remove Dupuytren nodules and release the contracted palmar fascia, generally at the base of the small and ring fingers, was the last resort measure taken by patients afflicted by severe Dupuytren Contractures. This type of surgery came with the same risks and lengthy recovery time associated with open surgery.

Today, an innovative new procedure first established in Europe is addressing these severe contractures less invasively. Known as the Percutaneous Needle Fasciotomy (PNF), or Needle Aponeurotomy (NA), this new procedure can address the contracture without cutting into the skin and disturbing surrounding soft tissue and nerves. This new minimally invasive surgical approach is an outpatient procedure and entails a local anesthetic and tiny needles.

Needles are applied to the affected areas, which are first identified with small marks. The needles are maneuvered in such a way that “punctures” the contracting tissue. The puncturing process weakens this contracting cord and initiates a breakdown. Fingers are freed from the contraction, allowing the hand to function normally.

Patients are then instructed on rehabilitative exercises in order to ensure full resumption of hand function.

The minimally invasive nature of the needle aponeurotomy procedure allows a faster recovery and more rapid return to activity. The risks associated with traditional open surgery are eliminated and patients report minimal pain following the procedure.

While this procedure is not available in every US city, Dr. Evan Collins is one of the few hand specialist who performs PNF.