this is Bobby Chhabra and this is our
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approach for open treatment of lateral
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epicondylitis here at the University of
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Virginia
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so I use a oblique incision just
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anterior to the lateral epicondyle
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careful dissection is performed down to
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the level of the fascia usually there's
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no significant cutaneous nerves at this
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region human stasis should be obtained
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and careful dissection performed
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exposing the underlying fascia and
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exposing the interval between the EC RL
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e C RL and e DC tendons I tend to keep
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the form pronated during this approach
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to make sure that there's no traction
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injury to the post or a nerve the
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interval between EC RL and e DC is
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carefully created and dissection is
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performed to expose the ECR B origin as
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shown here the pathology is at the level
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of frequently at the level of the EC RB
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origin and the goal for this procedure
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is to resect any of the abnormal tendon
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and as shown here this is done
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meticulously so that all abnormal tenant
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is resected this should also be done
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carefully as the radiocarpal joint is
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just below you and you should not
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violate the underlying cartilage the
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lateral epicondyle should be exposed the
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anterior portion should be exposed to
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prevent iatrogenic injury to the lateral
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collateral ligament the epicondyle is
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exposed in a partial epoch on elect amis
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performed I then drill the epicondyle to
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enhance healing with a point of four or
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five k-wire once this is completed the
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interval between the EC RL and e DC is
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closed incorporating the underline EC RB
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tissue so a side-to-side repair is
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obtained
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of the of the ECR B tendon an exam can
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be performed of the collateral ligament
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to ensure there's no postural our rotary
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instability it water tight closure is
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obtained to make sure you do not have
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problems with a Sonova synovial fish
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Allah that can develop if there's not a
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lot of tight closure hemostasis is
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obtained after dropping the tourniquet
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and the skin is closed using an
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absorbable suture I place the patient
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after it's appropriate dressing as a
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placed I placed the patient in a
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posterior splint until their first
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post-op visit in two weeks at which
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point therapy various therapy regimens
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are initiated