A unified approach to radial tunnel syndrome and lateral tendinosis

Mark Henry, Christopher Stutz

Research output: Contribution to journalReview article

18 Citations (Scopus)

Abstract

Two of the most common diagnoses assigned to patients presenting with lateral elbow and proximal forearm pain are lateral tendinosis and radial tunnel syndrome. Traditionally, these 2 conditions have been treated as distinct and separate entities with most patients being diagnosed with either one or the other, but not both. The extensor carpi radialis brevis (ECRB) and, to a lesser the degree, a portion of the extensor digitorum communis that form the conjoined lateral extensor tendon are thought to be primarily responsible for the excessive traction that induces lateral tendinosis (a degenerative process of microtears in the tendon with impaired healing), but the supinator blends with these same fibers and shares a role in the pathology. The supinator, primarily the arcade of Frohse, has been thought to play the majority role in compressing the posterior interosseous nerve in radial tunnel syndrome, but the undersurface thick tendon of the ECRB may also cause substantial nerve compression. Reduction of the linear tension transmitted by the ECRB is the common element in the various surgical treatments for lateral tendinosis, performed anywhere from directly at the lateral epicondyle to the distal myotendinous junction. Nerve decompression by division of fascial bands is the goal in surgery for radial tunnel syndrome. These 2 surgical approaches need not be mutually exclusive. In fact, this separation of the 2 clinical entities may play a role in the unpredictable results reported in the literature. This article presents a unified approach to treating both pathologies simultaneously including short-term clinical results.

Original languageEnglish (US)
Pages (from-to)200-205
Number of pages6
JournalTechniques in Hand and Upper Extremity Surgery
Volume10
Issue number4
DOIs
StatePublished - Dec 1 2006

Fingerprint

Tendinopathy
Tendons
Pathology
Radial Nerve
Traction
Elbow
Decompression
Forearm
Pain
Therapeutics

Keywords

  • Lateral tendinosis
  • Radial tunnel syndrome

ASJC Scopus subject areas

  • Surgery

Cite this

A unified approach to radial tunnel syndrome and lateral tendinosis. / Henry, Mark; Stutz, Christopher.

In: Techniques in Hand and Upper Extremity Surgery, Vol. 10, No. 4, 01.12.2006, p. 200-205.

Research output: Contribution to journalReview article

@article{3b80c7ab52e7402c94ef649adf3806f0,
title = "A unified approach to radial tunnel syndrome and lateral tendinosis",
abstract = "Two of the most common diagnoses assigned to patients presenting with lateral elbow and proximal forearm pain are lateral tendinosis and radial tunnel syndrome. Traditionally, these 2 conditions have been treated as distinct and separate entities with most patients being diagnosed with either one or the other, but not both. The extensor carpi radialis brevis (ECRB) and, to a lesser the degree, a portion of the extensor digitorum communis that form the conjoined lateral extensor tendon are thought to be primarily responsible for the excessive traction that induces lateral tendinosis (a degenerative process of microtears in the tendon with impaired healing), but the supinator blends with these same fibers and shares a role in the pathology. The supinator, primarily the arcade of Frohse, has been thought to play the majority role in compressing the posterior interosseous nerve in radial tunnel syndrome, but the undersurface thick tendon of the ECRB may also cause substantial nerve compression. Reduction of the linear tension transmitted by the ECRB is the common element in the various surgical treatments for lateral tendinosis, performed anywhere from directly at the lateral epicondyle to the distal myotendinous junction. Nerve decompression by division of fascial bands is the goal in surgery for radial tunnel syndrome. These 2 surgical approaches need not be mutually exclusive. In fact, this separation of the 2 clinical entities may play a role in the unpredictable results reported in the literature. This article presents a unified approach to treating both pathologies simultaneously including short-term clinical results.",
keywords = "Lateral tendinosis, Radial tunnel syndrome",
author = "Mark Henry and Christopher Stutz",
year = "2006",
month = "12",
day = "1",
doi = "10.1097/01.bth.0000231580.32406.71",
language = "English (US)",
volume = "10",
pages = "200--205",
journal = "Techniques in Hand and Upper Extremity Surgery",
issn = "1089-3393",
publisher = "Lippincott Williams and Wilkins",
number = "4",

}

TY - JOUR

T1 - A unified approach to radial tunnel syndrome and lateral tendinosis

AU - Henry, Mark

AU - Stutz, Christopher

PY - 2006/12/1

Y1 - 2006/12/1

N2 - Two of the most common diagnoses assigned to patients presenting with lateral elbow and proximal forearm pain are lateral tendinosis and radial tunnel syndrome. Traditionally, these 2 conditions have been treated as distinct and separate entities with most patients being diagnosed with either one or the other, but not both. The extensor carpi radialis brevis (ECRB) and, to a lesser the degree, a portion of the extensor digitorum communis that form the conjoined lateral extensor tendon are thought to be primarily responsible for the excessive traction that induces lateral tendinosis (a degenerative process of microtears in the tendon with impaired healing), but the supinator blends with these same fibers and shares a role in the pathology. The supinator, primarily the arcade of Frohse, has been thought to play the majority role in compressing the posterior interosseous nerve in radial tunnel syndrome, but the undersurface thick tendon of the ECRB may also cause substantial nerve compression. Reduction of the linear tension transmitted by the ECRB is the common element in the various surgical treatments for lateral tendinosis, performed anywhere from directly at the lateral epicondyle to the distal myotendinous junction. Nerve decompression by division of fascial bands is the goal in surgery for radial tunnel syndrome. These 2 surgical approaches need not be mutually exclusive. In fact, this separation of the 2 clinical entities may play a role in the unpredictable results reported in the literature. This article presents a unified approach to treating both pathologies simultaneously including short-term clinical results.

AB - Two of the most common diagnoses assigned to patients presenting with lateral elbow and proximal forearm pain are lateral tendinosis and radial tunnel syndrome. Traditionally, these 2 conditions have been treated as distinct and separate entities with most patients being diagnosed with either one or the other, but not both. The extensor carpi radialis brevis (ECRB) and, to a lesser the degree, a portion of the extensor digitorum communis that form the conjoined lateral extensor tendon are thought to be primarily responsible for the excessive traction that induces lateral tendinosis (a degenerative process of microtears in the tendon with impaired healing), but the supinator blends with these same fibers and shares a role in the pathology. The supinator, primarily the arcade of Frohse, has been thought to play the majority role in compressing the posterior interosseous nerve in radial tunnel syndrome, but the undersurface thick tendon of the ECRB may also cause substantial nerve compression. Reduction of the linear tension transmitted by the ECRB is the common element in the various surgical treatments for lateral tendinosis, performed anywhere from directly at the lateral epicondyle to the distal myotendinous junction. Nerve decompression by division of fascial bands is the goal in surgery for radial tunnel syndrome. These 2 surgical approaches need not be mutually exclusive. In fact, this separation of the 2 clinical entities may play a role in the unpredictable results reported in the literature. This article presents a unified approach to treating both pathologies simultaneously including short-term clinical results.

KW - Lateral tendinosis

KW - Radial tunnel syndrome

UR - http://www.scopus.com/inward/record.url?scp=33845676080&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33845676080&partnerID=8YFLogxK

U2 - 10.1097/01.bth.0000231580.32406.71

DO - 10.1097/01.bth.0000231580.32406.71

M3 - Review article

C2 - 17159475

AN - SCOPUS:33845676080

VL - 10

SP - 200

EP - 205

JO - Techniques in Hand and Upper Extremity Surgery

JF - Techniques in Hand and Upper Extremity Surgery

SN - 1089-3393

IS - 4

ER -