Lateral epicondylitis treatment by extensor carpi radialis fasciotomy and radial nerve decompression: is outcome influenced by the occupational disease compensation aspect?

ABSTRACT

INTRODUCTION: The etiology, treatment, and patient management in cases of chronic epicondylitis, within the legislation on occupational disease, remain highly controversial. HYPOTHESIS: Recognition as an occupational disease has a negative influence on the functional result of epicondylitis treated with aponeurotomy and neurolysis of the motor branch of the radial nerve. PATIENTS AND METHODS: Twenty-eight patients (30 cases of epicondylitis) were operated between January 2007 and January 2008. There were nine men and 19 women whose mean age was 46.1 years. A preoperative EMG found anomalies in the deep posterior interosseous nerve in all cases. Patients were divided into two groups one group of patients recognized as having an occupational disease and a group of patients whose disease was not considered occupation-related. RESULTS: The patients were seen at follow-up at a mean 21.8 months. In the group of patients with occupational disease, there were six excellent, nine good, and five acceptable results; in the second group, there were six excellent, two good, and two acceptable results. CONCLUSION: Recognition of epicondylitis as an occupational disease has a significant influence only on the time to pain relief and the result on strength. LEVEL OF EVIDENCE Level IV. Retrospective study.