- may begin as a microtear between the pronator teres and the FCR;
- often associated w/ ulnar neuritis (see cubital tunnel);
- tenderness over the origin of the forearm flexors;
- resisted pronation and/or flexion will elicit pain in most patients;
- grip strength is usually be impaired;
- w/ concomitatnt cubital tunnel may find;
- tenderness over the ulnar nerve;
- positive Tinel sign;
- decrease 2 point in litte finger;
- intrinsic atrophy;
- may see calcification at the flexor origin;
- Non Operative Treatment:
- expected to be successful in the majority of patients;
- counterforce brace (circumferential orthosis)
- steroids: as noted by Stahl and Kaufman, a steroid injection (methylprednisolone 40 mg) afforded some relief a 6 weeks, but no
apparent relief at 3 months;
- Operative Treatment:
- debridement w/ release of flexor pronator origin or reattachement of muscle origin;
- often only a partial debridement of the FCR and the prontator teres origin will be required;
- partial cortical shaving of the medial epicondyle helps promote healing;
- w/ concomitant ulnar neuritis, isolated release of the cubital tunnel may
not suffice, since the nerve will continue to lie in a bed of inflammation;
- in stead, an anterior transposition will generally be necessary;
- since the flexor pronator origin will be partially released and debrided as a part of the procedure, consider performing a sub-
Operative treatment of medial epicondylitis. Influence of concomitant ulnar neuropathy at the elbow.
The efficacy of an injection of steroids for medial epicondylitis. A prospective study of 60 elbows.
Resection and repair for medial tennis elbow. A prospective analysis.
Original Text by Clifford R. Wheeless, III, MD.
Last updated by Data Trace Staff on Thursday, May 31, 2012 2:44 pm