A Comparative Study Between Denervation and Extensor Release for Management of Resistant Tennis Elbow.

Abstract

Extensor tendon release for tennis elbow is fraught with complications as persistence of pain because of adhesions together with weakness of wrist extension. Denervation of the epicondylar region through division of branches of posterior cutaneous nerve of the forearm (PCNF) was proposed to alleviate pain without drawbacks of tendon release. The first group included 19 patients treated through dividing PCNF. The second group included 23 patients treated through tendon release. Inclusion criteria included symptoms for 6 months or longer. Clinical diagnosis was based on positive resisted wrist extension and resisted forearm pronation tests. Division of branches of PCNF in the denervation group and release of extensor carpi radialis brevis tendinous origin in the release group were done. The follow-up was 37 months. In the denervation group, 17 patients (92%) reported no pain compared with 15 patients (67%) in the release group. In the denervation group, hand grip strength had an average of 72 lb (91%) compared with 63 lb (77%) for the release group (P = 0.04). Patients of the denervation group had an average Mayo Elbow Performance Score of 95 points compared with 87 for the release group (P = 0.37). Denervation of the elbow for management of tennis elbow is a simple safe procedure.