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Tennis elbow, or lateral epicondylitis, is one of the most common elbow problems seen by an orthopedic surgeon. It is actually a tendinitis of the muscle called the extensor carpi radialis brevis which attaches to the lateral epicondyle of the humerus. 網球肘, 或側上髁炎, 是骨外科最常見的手肘問題之一, 事實上是肌肉的肌腱炎, 這肌肉稱之為短橈側腕伸肌, 接到肱骨的側上髁處. |
It may be caused by a sudden injury or by repetitive use of the arm. Many doctors feel that micro tears in the tendon lead to a hyper-vascular phenomenon resulting in pain. The pain is usually worse with strong gripping with the elbow in an extended position, as in a tennis back hand stroke, but this problem can occur in golf and other sports as well as with repetitive use of tools.
手臂反覆使用或突然受傷可能導致網球肘, 許多醫師感覺到肌腱的微小撕裂導致血流過多現象造成疼痛. 手肘在伸張位置強力握拍會使疼痛加重, 例如在網球反手拍打擊時. 但如高爾夫球和其他運動和反覆使用工具也可能發生這個問題.
Before surgery is considered a trial of at least six months of conservative treatment is indicated and consists of a properly placed forearm brace and modification of elbow activities. I have not found anti-inflammatory medication or physical therapy to be of any value. If the above treatment is not helpful, a cortisone injection can be beneficial but no more than three injections are recommended in any one location in a year.
考慮開刀手術之前, 可以嘗試用保守療法至少六個月, 包括適當地放置前臂支撐物和手肘活動的修正調整. 我從未發現抗發炎藥或物理治療有任何價值. 如果以上治療沒有幫助, 可體松注射可能有好處但是一年之內一個位置不建議超過三次注射.
Conservative treatment is in two phases and after Phase I (Pain relief) has been successful, Phase II, (Prevention of recurrence) is equally as important and involves stretching and then later strengthening exercises, so the micro tears will not occur in the future.
兩階段保守治療, 第一階段(止痛)成功之後, 第二階段(預防再發)同樣重要而包括伸張然後稍後的加強肌力的運動, 因此將來不再發生微小撕裂的狀況.
When conservative treatment has failed, then surgery is indicated. Many procedures have been described. Procedures as simple as percutaneous release of the tendon off of the bone have been described and more recently arthroscopic procedures or other procedures involving the joint and resection of a ligament as well have been described.
當保守治療失敗時, 就要考慮開刀手術了. 有好多手術方法. 簡單如皮下肌腱由骨解離手術曾被描述, 最近關節鏡手術或其他有關關節的方法和韌帶切除術都曾被提及
The most popular procedure today is a simple excision of diseased tissue from within the tendon, shaving down the bone and re-attachment of the tendon. This can be performed as an outpatient procedure with regional anesthesia (where only the arm goes to sleep) and through a relatively small incision of approximately 3” long. 85-90% of patients with this technique are typically able to perform full activities without pain after a recuperation of two to three months. Approximately 10-12% of patients have improvement but with some pain during aggressive activities and only 2-3% of patients have no improvement.
今天最受歡迎的手術是來自肌腱之內一個有病組織的簡單切除，刮骨和肌腱的再附著。這手術能在門診作, 局部麻醉 （僅手臂沉沉睡去）和經過相對小的切口大約 3英吋長。85-90% 的開過這種手術的病人在2-3個月的恢復後, 能典型地無痛完成所有的動作。大約 10-12% 病人在積極的活動可有進步但是仍有一些疼痛,只有 2-3%的病人沒有進步。
Text prepared by David M. Auerbach, MD
Southern California Orthopedic Institute
作為一個談網球拍|網球的部落格，實在有必要寫幾篇比較基本的介紹性文章，讓本部落格的讀者可以對網球拍|網球有較完整和正確的認識。不過說實在的越簡單的問題真的是越難回答..我今天想先就網球拍|網球的部分來談。網路上有關於網球拍|網球的文章不勝枚舉，這次我打算從一個非技術面的角度來看待網球拍|網球, 從網球拍|網球的內部抽離，站在一個更高的位置重新檢視它，希望可以由這樣的思考重新發現網球拍|網球的許多不同面貌！.網球拍|網球到底是什麼？請捫心自問，我這樣作，是否會幫到網球拍|網球需求者？如果不存在網球拍|網球需求，我是否還會這樣作?以上這段話不是我說的，也不是其他任何人的名言，這句話摘自官方。基本上官方對於網球拍|網球的立場，從這句話表露無遺！為什麼我們需要考慮網球拍|網球者的立場？答案非常簡單，因為沒有網球拍|網球者就沒有網球拍|網球，也不必網球拍|網球！減肥|瘦身|減重|瘦身餐|台中|減肥食譜|減肥日記|減肥瘦身|網球|網球拍|網球王子|網球拍拍|催眠|nlp|神經語言程式學|皮膚疾病|皮膚過敏|皮膚癢|皮膚病|美白|健康|醫療|疾病|