Medial epicondylitis Discussion

Medial epicondylitis is a painful condition involving the medial aspect of the elbow, and is a variant of tennis elbow. It may be due to a variety of problems, either singly or in combination. Etiologies include bursitis, periostitis, partial rupture of the common flexor tendon origin, ulnohumeral synovitis, calcific tendinitis, as well as ulnar neuritis. The relationship of tennis elbow to occupational factors is not clear. Tennis elbow is common, affecting seven to ten percent of the adult male population at any given time. Although commonly thought to be associated with repetitive or strenuous work, published studies indicate both that tennis elbow is just as common among sedentary workers as manual laborers, and that specific working activities do not appear to increase the incidence of tennis elbow. However, when present, tennis elbow is considerably more disabling in those who perform manual work. The majority of patients respond to prolonged conservative treatment, which has been reported to be successful in about 90 percent of patients. Surgical intervention is reserved for patients who have failed conservative management. Bone scan may be helpful in evaluating the degree of periosteal inflammation.A variety of surgical procedures may be employed, depending on the exact working diagnosis and intraoperative findings. Satisfactory results following surgery can be expected in about 80 percent of patients. Patients return to work an average of six weeks following surgery, longer if problem is compensation related. Some permanent loss of grip strength and loss of full elbow extension has been reported in a sizeable minority of patients, for reasons which are not clear. Late recurrence may be a problem with either conservative or surgical management.

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