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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