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Saturday, March 18, 2000

Mixed results for decompression of radial nerve

Mixed results have been reported for decompression of the radial nerve for forearm pain, said researchers in a study presented in scientific exhibit 350. Radial tunnel syndrome may present with symptoms similar to lateral epicondylitis, said Richard Steinfeld, MD, senior resident, orthopaedics, Mayo Clinic, Rochester, Minn. who presented the study.

"It has been suggested that these conditions may co-exist," said Dr. Steinfeld. "This study compares results following a combined release of the radial tunnel (RT) and lateral epicondyle (LE) with the results following release of the RT alone or in combination with portions of the extensor mechanism for patients with chronic anterolateral forearm pain."

A retrospective review of 71 patients (82 limbs) from 1975 to 1994 was undertaken for patients who underwent surgical procedures for disabling symptoms of chronic lateral forearm pain. There were 31 men and 40 women ranging in age from 24 to 65 years (average age 41). Sixty-three were dominant extremities. Forty-two patients were involved in worker's compensation cases. Sixty patients received injections to the lateral epicondyle and 30 to the radial tunnel prior to surgery. The average time from symptom onset to surgery was 24 months.

Results were based on the type of surgical release: complete release of RT and LE (RT+LE), radial tunnel release with ECRB tenotomy (RT+ECRB), or radial tunnel release without ECRB tenotomy (RT-ECRB).

Follow-up ranged from 3 to 110 months (average 3.5 years). Forty LE and 16 RT injections resulted in temporary relief of symptoms. Eleven revision surgeries were performed. Seventy-nine percent (56/71) of patients reported improvement or relief of symptoms following primary surgery. Combined RT+LE release resulted in improvement or complete relief of symptoms in 97 percent (32/33). Sixty-one percent (14/23) reported relief with release of RT and ECRB tenotomy (RT+ECRB). Release of the RT alone (RT-ECRB) resulted in improvement or relief in 67 percent (10/15).

Co-author of the study is Peter C. Amadio, MD, professor of orthopaedics, Mayo Clinic, Rochetster, Minn.

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Last modified 24/February/2000 by IS