Lateral epicondylitis(LE)is a chronic aseptic inflammatory condition caused by repetitive microtrauma and excessive overload of the extensor carpi radialis brevis muscle.This is the most common cause of musculoskeleta...Lateral epicondylitis(LE)is a chronic aseptic inflammatory condition caused by repetitive microtrauma and excessive overload of the extensor carpi radialis brevis muscle.This is the most common cause of musculoskeletal pain syndrome in the elbow,inducing significant pain and limitation of the function of the upper limb.It affects approximately 1-3%of the population and is frequently seen in racquet sports and sports associated with functional overload of the elbow,such as tennis,squash,gymnastics,acrobatics,fitness,and weight lifting.Typewriters,artists,musicians,electricians,mechanics,and other professions requiring frequent repetitive movements in the elbow and wrists are also affected.LE is a leading causation for absence from work and lower sport results in athletes.The treatment includes a variety of conservative measures,but if those fail,surgery is indicated.This review summarizes the knowledge about this disease,focusing on risk factors,expected course,prognosis,and conservative and surgical treatment approaches.展开更多
In recent years, the measures on treatment of humeral epicondylitis with acupuncture and moxibustion were increased daily and a certain progression had been achieved. It had been synthesized in the paper various thera...In recent years, the measures on treatment of humeral epicondylitis with acupuncture and moxibustion were increased daily and a certain progression had been achieved. It had been synthesized in the paper various therapies of acupuncture and moxibustion in treatment of the disease, named filiform needling technique, special needling, warm needling and comprehensive therapy, as well as therapeutic evaluations and mechanisms. Additionally, the problems and shortcomings existed at present had been proposed in the paper.展开更多
In the present paper, the authors summarize their results of 30 cases of external humeral epicondylitis treated with thermal acupuncture of Chongyang (ST 42) and Ashi points. After 3-15 sessions of treatment, of the 3...In the present paper, the authors summarize their results of 30 cases of external humeral epicondylitis treated with thermal acupuncture of Chongyang (ST 42) and Ashi points. After 3-15 sessions of treatment, of the 30 cases, 24 (80%) were cured, and the rest 6 (20%) responded with apparent improvement in their symptoms.展开更多
Background: Several treatment options have been proposed to treat lateral epicondylitis. Both Platelet rich plasma (PRP) and Extra-corporeal Shock Wave Therapy (ESWT) are new treatment modalities for tendinopathy. Pat...Background: Several treatment options have been proposed to treat lateral epicondylitis. Both Platelet rich plasma (PRP) and Extra-corporeal Shock Wave Therapy (ESWT) are new treatment modalities for tendinopathy. Patients and Methods: Thirty seven patients suffering from chronic lateral epicondylitis (tennis elbow) for at least six months were treated in this study. The patients were divided into two treatment groups, the first group including 20 patients treated by ESWT and the second group including 17 patients treated by local injection of platelet-rich plasma. The results were evaluated using the visual analogue scale and the DASH score. Results: In the first group (treated by ESWT), the average follow-up period was 21.55 months. The average VAS improved from 8.2 to 1.95 and the average DASH score improved from 72.25 to 51.7. Moreover, 11 cases were satisfied (55%), 3 cases (15%) were satisfied with reservation and 6 cases (30%) were not satisfied. In the second group (treated by PRP), the average follow-up period was 18.47 months. The average VAS improved from 8.52 to 1.47, the DASH score improved from 72 to 48.23. Concerning patient satisfaction, 13 cases were satisfied (83.33%), 3 cases (10.52%) were satisfied with reservation and 1 case (5.55%) was not satisfied. Conclusion: Platelet rich plasma was proved to achieve superior results when compared to ESWT as regards pain relief, improvement of elbow function and patient satisfaction at follow-up.展开更多
External humeral epicondylitis, also known as brachioradial bursitis, popularly called “tennis elbow” refers to the acute or chronic myofascitis, the injury of the common extensor tendon of the humeral epicondyle. T...External humeral epicondylitis, also known as brachioradial bursitis, popularly called “tennis elbow” refers to the acute or chronic myofascitis, the injury of the common extensor tendon of the humeral epicondyle. The authors have recently treated 62 cases of the disease by means of stiletto needle, the therapeutic effect of the treatment is so satisfactory, following is the report of the treatment.展开更多
Objective To observe the clinical effects of wrist-ankle acupuncture on external humeral epicondylitis. Methods Seventy-two cases diagnosed as external humeral epicondylitis were brought into the study. Horizontal nee...Objective To observe the clinical effects of wrist-ankle acupuncture on external humeral epicondylitis. Methods Seventy-two cases diagnosed as external humeral epicondylitis were brought into the study. Horizontal needling was used at upper area 3, upper area 4 and upper area 5 near wrists with long filiform needles. The frequency was once a day, and a course included 10 times. Results 27 cases got cured, 36 cases were marked effective, 5 cases were effective and 4 cases were failed after 1 course to 5 courses of treatment. The total effective rate was 94.5%. Conclusion Wrist-ankle acupuncture is a simple and effective therapy on external humeral epicondylitis.展开更多
Objective:To observe the clinical effect of electroacupuncture(EA)at Zhouling(Extra)and Ashi points in combination with blood-letting cupping for the treatment of external humeral epicondylitis(EHE).Methods:Thirty EHE...Objective:To observe the clinical effect of electroacupuncture(EA)at Zhouling(Extra)and Ashi points in combination with blood-letting cupping for the treatment of external humeral epicondylitis(EHE).Methods:Thirty EHE patients were treated with EA at Zhouling(Extra)and Ashi points in combination with blood-letting cupping,once every 2 days,twice a week,4 times as one course of treatment,and2 successive courses of treatment were given.Before treatment,after 1 course of treatment,and after 2 courses of treatment,the visual analogue scale(VAS)score and Mayo elbow performance score(MEPS)were adopted to evaluate the curative effect.Results:Before treatment,the VAS score of patients was 7.81±1.39.After 1 course of treatment and after 2 courses of treatment,it was 4.77±1.56 and 2.95±1.23 respectively,lowered than before treatment,and the difference was statistically significant(both P<0.01).Before treatment,the Mayo score of patients was 32.17±19.31.After 1 course of treatment and after 2 courses of treatment,it was 47.39±19.85 and85.21±20.47 respectively,increased than before treatment,and the difference was statistically significant(both P<0.01).Of the 30 patients,5 were cured,accounting for 16.67%;14 cases obviously effective,accounting for 46.67%;8 cases effective,accounting for 26.67%;3 cases ineffective,accounting for 10.00%,and the total effective rate was 90.00%.Conclusion:EA at Zhouling(Extra)and Ashi points and blood-letting cupping used in combination are remarkably effective in the treatment of EHE,being worthy for popularization.展开更多
Lateral epicondylitis （LE） is a common musculoskeletal problem. The incidence is estimated to be 0.4%-0.7% per year in general practice, and between 1% and 3% per year in the adult general populationJ2） LE results ...Lateral epicondylitis （LE） is a common musculoskeletal problem. The incidence is estimated to be 0.4%-0.7% per year in general practice, and between 1% and 3% per year in the adult general populationJ2） LE results from repetitive micro-trauma by overuse of the wrist extensor musculature, which ultimately leads to failure of the common extensor tendon,展开更多
目的:肱骨髁上骨折是儿童肘部骨折中最常见的类型,对于移位的肱骨髁上骨折,闭合复位固定是首选的治疗方案,但是对于选择合适的技术仍存在分歧。因而,此次荟萃分析旨在评估单侧和双侧交叉钉固定对儿童肱骨髁上骨折的疗效,为临床治疗提供...目的:肱骨髁上骨折是儿童肘部骨折中最常见的类型,对于移位的肱骨髁上骨折,闭合复位固定是首选的治疗方案,但是对于选择合适的技术仍存在分歧。因而,此次荟萃分析旨在评估单侧和双侧交叉钉固定对儿童肱骨髁上骨折的疗效,为临床治疗提供参考。方法:全面检索PubMed、Embase、Web of Science和the Cochrane Library建库以来至2023-01-06发表的相关随机对照试验,比较儿童肱骨髁上骨折内外侧交叉固定和单纯外侧固定两种术式的疗效差异,主要观察指标是影像学结果(Baumann角丢失、提携角丢失)、肘关节功能和常见并发症(医源性尺神经损伤、针道感染)。结果:①共纳入18项研究;②两组Baumann角丢失(P=0.47)、提携角丢失(P=0.47)情况相比无统计学差异;外侧固定组与内外侧交叉固定组关节功能恢复评分优秀的患儿比例分别为70.7%和74.9%,差异无显著性意义(P=0.12);两组在针道感染发生率上同样无统计学差异(P=0.9),但内外侧交叉固定组医源性尺神经损伤的风险更高(P=0.02);③然而,当采用小切口联合探查时,内外侧交叉固定组尺神经损伤的频率与外侧固定组相比无统计学差异(P=0.2);④在GartlandⅢ型亚组中,两组在关节功能恢复评分优秀率(P=0.13)、尺神经损伤(P=0.13)和针道感染(P=0.61)方面均无统计学差异。结论:荟萃分析结果显示,与外侧固定技术相比,内外侧交叉固定方法更容易造成前臂的医源性神经损伤,但同时也增加了结构的稳定性。不过,通过小切口方法联合内外侧交叉固定似乎可以降低患者神经损伤的风险。因此,儿童肱骨髁上骨折治疗采用小切口结合内外侧交叉固定可能是一种既保证结构稳定、又安全的固定方法。展开更多
Lateral elbow tendinopathy(LET) is a common musculoskeletal/sports injury. A plethora of physiotherapy techniques has been proposed in the management of LET. The exercise programme is the most common treatment in the ...Lateral elbow tendinopathy(LET) is a common musculoskeletal/sports injury. A plethora of physiotherapy techniques has been proposed in the management of LET. The exercise programme is the most common treatment in the management of LET. The optimal protocol of exercise programme is still unknown. The effectiveness of the exercise programme is low when it is applied as monotherapy. Therefore, exercise programme is combined with other physiotherapy modalities such as soft tissue techniques, external support, acupuncture, manual therapy and electrotherapy, in the treatment of LET. Future research is needed to determine which treatment strategy combined with exercise programme will provide the best results in LET rehabilitation.展开更多
Lateral elbow tendinopathy(LET) is one of the two most common tendinopathies of the upper limb. The most effective treatment in the management of LET is the exercise program. Clinicians combine exercise program with o...Lateral elbow tendinopathy(LET) is one of the two most common tendinopathies of the upper limb. The most effective treatment in the management of LET is the exercise program. Clinicians combine exercise program with other physiotherapy, electrotherapeutic and no, techniques. Extracorporeal shock wave therapy(ESWT) is one of the most common recommended electrotherapeutic modalities for the management of LET. Further research is needed to find out the optimal treatment protocol of ESWT in the management of展开更多
BACKGROUND Coronal shear fractures of the distal humerus are rare injuries and are technically challenging to manage.Open reduction and internal fixation(ORIF)has become the preferred treatment because it provides ana...BACKGROUND Coronal shear fractures of the distal humerus are rare injuries and are technically challenging to manage.Open reduction and internal fixation(ORIF)has become the preferred treatment because it provides anatomical reduction,stable internal fixation,and early motion,but the optimal surgical approach remains controversial.CASE SUMMARY We report three cases of coronal shear fractures of the distal humerus treated successfully by ORIF via a novel surgical approach,in which lateral epicondyle osteotomy was performed based on the extended lateral approach.We named the novel surgical approach the lateral epicondyle osteotomy approach.All patients underwent surgical treatment and were discharged successfully.All patients had excellent functional results according to the Mayo elbow performance score.The average range of motion was 118°in flexion/extension and 172°in pronation/supination.Only case 2 had a complication,which was implant prolapse.CONCLUSION We demonstrated that the lateral epicondyle osteotomy approach in ORIF is effective and safe for coronal shear fractures of the distal humerus.展开更多
目的观察郑氏手法治疗肱骨外上髁炎的治疗效果。方法将2021年8月—2022年1月该院筋伤科门诊收治的60例肱骨外上髁炎病人按照纳入顺序用随机数字表随机分类法随机分成两组,每组30例,治疗组30例病人予郑氏手法治疗,对照组30例病人予局部...目的观察郑氏手法治疗肱骨外上髁炎的治疗效果。方法将2021年8月—2022年1月该院筋伤科门诊收治的60例肱骨外上髁炎病人按照纳入顺序用随机数字表随机分类法随机分成两组,每组30例,治疗组30例病人予郑氏手法治疗,对照组30例病人予局部封闭治疗,两组疗程均是2周。疗程结束后评估两组总体疗效,治疗前后视觉模拟评分法(visual analog scale,VAS)评分,治疗前后Mayo肘关节功能评分,治疗前后美国特种外科医院(Hospital for Special Surgery,HSS)肘关节功能评分,治疗前后肘关节局部压痛阈值。结果治疗组的总有效率为88.89%(24/27),优于对照组总有效率81.48%(22/27)(P<0.05);两组治疗后VAS评分均降低,两组差异无统计学意义(P>0.05);两组治疗后Mayo肘关节评分和HSS肘关节评分均增高,治疗组评分明显高于封闭组(P<0.05);两组治疗后Mayo肘关节评分和HSS肘关节评分均增高,治疗组评分明显高于封闭组(P<0.05);两组治疗后肘关节局部压痛阈值较治疗前均有提升,治疗组肘关节局部压痛阈值明显高于封闭组(P<0.05)。结论郑氏手法治疗肱骨外上髁炎疗效优于局部封闭治疗,值得临床推广应用。展开更多
目的观察石墨烯新型灸贴与活络止痛贴治疗肱骨外上髁炎的疗效差异,探讨石墨烯新型灸贴的有效性。方法按照随机数字表法将72例肱骨外上髁炎的患者平均分到试验组和对照组,试验组采用石墨烯新型灸贴,对照组采用活络止痛贴,2组均选取患侧...目的观察石墨烯新型灸贴与活络止痛贴治疗肱骨外上髁炎的疗效差异,探讨石墨烯新型灸贴的有效性。方法按照随机数字表法将72例肱骨外上髁炎的患者平均分到试验组和对照组,试验组采用石墨烯新型灸贴,对照组采用活络止痛贴,2组均选取患侧的阿是穴(最痛点)、曲池和手三里,每穴1贴,隔日贴敷1次,每次贴敷6 h,2组均治疗14 d。分别对比治疗前后的视觉模拟评分(Visual Analogue Scale,VAS)、上肢功能评定量表评分(Disability of Arm Shoulder and Hand,DASH)及无痛握力值(Pain-free Grip Strength,PFG)。结果2组患者的VAS评分和DASH评分均降低(P<0.05),PFG值较治疗前增高(P<0.01)。组间比较发现,试验组总有效率为93.90%;对照组总有效率为88.20%。结论石墨烯新型灸贴治疗肱骨外上髁炎的疗效优于活络止痛贴。展开更多
目的:探讨理筋拔戳揉捻法治疗肱骨外上髁炎(liater epicondylitis,LE)的临床疗效。方法:自2018年1月至2021年12月采用多中心随机对照研究方法,分别在中国中医科学院望京医院、北京电力医院、北京丰盛骨伤科专科医院收集LE患者192例,采...目的:探讨理筋拔戳揉捻法治疗肱骨外上髁炎(liater epicondylitis,LE)的临床疗效。方法:自2018年1月至2021年12月采用多中心随机对照研究方法,分别在中国中医科学院望京医院、北京电力医院、北京丰盛骨伤科专科医院收集LE患者192例,采用随机数字表法分为治疗组和对照组。治疗组96例,男36例,女60例;年龄28~60(41.20±5.50)岁;病程1~14(5.24±1.35)d;予理筋拔戳揉捻法配合肘关节练功法治疗,隔日1次,治疗2周。对照组96例,男33例,女63例;年龄26~60(43.35±7.75)岁;病程1~14(5.86±1.48)d,予外用扶他林配合护肘关节固定治疗,治疗2周。分别于治疗前及治疗后第1、3、5、7、11、13天比较疼痛视觉模拟评分(visual analogue scale VAS)、美国特种医院评分系统(Hospital for Surgery Scoring System,HSS)、肘关节旋前及旋后角度、腕关节掌屈及背伸角度、肘关节压痛,并比较治疗前及治疗结束后美国特种医院评分系统2(Hospital for Surgery Scoring System2,HSS2)肘关节评分。结果:所有患者获得随访,时间10~14(12.0±1.6)d。治疗组及对照组治疗前VAS分别为(6.83±1.36)、(6.79±1.58)分,末次治疗后降低至(1.49±1.09)、(2.11±1.81)分,其中治疗后第1、3、5、7、9、11、13天,治疗组VAS较对照组明显降低(P<0.05)。两组治疗前HSS评分分别为(61.73±11.00)、(36.47±12.45)分,末次治疗后提高至(94.42±5.90)、(91.44±9.11)分,其中治疗后第1、3、5、7、9、11、13天,治疗组HSS显著高于对照组(P<0.05)。治疗后第5天,治疗组肘关节外旋角度、内旋角度分别为(66.41±12.69)°、(66.35±13.54)°,对照组为(62.08±16.03)°、(61.77±16.35)°;治疗后第7天,治疗组肘关节外旋角度、内旋角度分别为(69.79±12.64)°、(70.02±13.55)°,对照组为(65.28±15.86)°、(65.09±16.67)°,以上时间点治疗组肘关节活动度大于对照组(P<0.05)。治疗后第5天,治疗组腕关节背伸、掌屈角度为(39.43±15.94)°、(46.68±11.10)°,对照组为(38.51±18.49)°、(44.27±13.58)°;治疗后第7天,治疗组腕关节背伸、掌屈角度分别为(42.52±16.50)°、(49.23±10.96)°,对照组为(41.18±20.09)°、(46.64±14.63)°;治疗组腕关节活动度大于对照组(P<0.05)。治疗后第13天,治疗组HSS2为(93.61±6.32)分,高于对照组(92.06±7.94)分(P<0.05)。两组各时间点肘关节压痛值比较,差异无统计学意义(P>0.05)。结论:扶他林外用联合肘部固定和理筋拔戳揉捻手法均能有效改善LE的症状,理筋拔戳揉捻手法较扶他林外用治疗具有止痛时间长和恢复肘关节功能更好的优势。展开更多
目的探讨基于灶点理论的弧刃针疗法治疗顽固性网球肘的临床疗效。方法收集64例顽固性网球肘患者,采用随机数字表法分为对照组和观察组。其中对照组32例,采用局部痛点注射治疗。观察组32例,采用弧刃针疗法治疗,每周治疗1次,均治疗2次,分...目的探讨基于灶点理论的弧刃针疗法治疗顽固性网球肘的临床疗效。方法收集64例顽固性网球肘患者,采用随机数字表法分为对照组和观察组。其中对照组32例,采用局部痛点注射治疗。观察组32例,采用弧刃针疗法治疗,每周治疗1次,均治疗2次,分别记录并比较两组患者治疗前、治疗后1、2、4及24周随访的疼痛数字评分(numberal rating scale,NRS)、肘关节功能评分(Mayo elbow perfor⁃mance score,MEPS)、肩臂手残障(disabilities of the arm,shoulder and hand,DASH)评分以及24周随访时的疾病的疗效评分(Wangxuechang diease efficacy score,WDES)。结果治疗过程中两组患者均未见不良事件发生。两组患者治疗前的NRS、MEPS及DASH差异均无统计学意义(P>0.05);治疗后各时期,两组NRS、MEPS、DASH及24周随访时的WDES较治疗前均改善,治疗1周后,两组NRS差异无统计学意义(P>0.05),治疗2、4及24周随访时的NRS观察组低于对照组;治疗后1、2、4及24周随访时,观察组DASH评分低于对照组,MEPS评分高于对照组,差异有统计学意义(P<0.05),治疗24周后随访时的WDES,观察组优于对照组,差异有统计学意义(P<0.05)。结论局部痛点注射及弧刃针灶点松解治疗顽固性网球肘早期均能缓解疼痛,改善肘关节功能,而局部痛点注射治疗后远期效果欠佳,观察组治疗效果逐渐提升。展开更多
文摘Lateral epicondylitis(LE)is a chronic aseptic inflammatory condition caused by repetitive microtrauma and excessive overload of the extensor carpi radialis brevis muscle.This is the most common cause of musculoskeletal pain syndrome in the elbow,inducing significant pain and limitation of the function of the upper limb.It affects approximately 1-3%of the population and is frequently seen in racquet sports and sports associated with functional overload of the elbow,such as tennis,squash,gymnastics,acrobatics,fitness,and weight lifting.Typewriters,artists,musicians,electricians,mechanics,and other professions requiring frequent repetitive movements in the elbow and wrists are also affected.LE is a leading causation for absence from work and lower sport results in athletes.The treatment includes a variety of conservative measures,but if those fail,surgery is indicated.This review summarizes the knowledge about this disease,focusing on risk factors,expected course,prognosis,and conservative and surgical treatment approaches.
文摘In recent years, the measures on treatment of humeral epicondylitis with acupuncture and moxibustion were increased daily and a certain progression had been achieved. It had been synthesized in the paper various therapies of acupuncture and moxibustion in treatment of the disease, named filiform needling technique, special needling, warm needling and comprehensive therapy, as well as therapeutic evaluations and mechanisms. Additionally, the problems and shortcomings existed at present had been proposed in the paper.
文摘In the present paper, the authors summarize their results of 30 cases of external humeral epicondylitis treated with thermal acupuncture of Chongyang (ST 42) and Ashi points. After 3-15 sessions of treatment, of the 30 cases, 24 (80%) were cured, and the rest 6 (20%) responded with apparent improvement in their symptoms.
文摘Background: Several treatment options have been proposed to treat lateral epicondylitis. Both Platelet rich plasma (PRP) and Extra-corporeal Shock Wave Therapy (ESWT) are new treatment modalities for tendinopathy. Patients and Methods: Thirty seven patients suffering from chronic lateral epicondylitis (tennis elbow) for at least six months were treated in this study. The patients were divided into two treatment groups, the first group including 20 patients treated by ESWT and the second group including 17 patients treated by local injection of platelet-rich plasma. The results were evaluated using the visual analogue scale and the DASH score. Results: In the first group (treated by ESWT), the average follow-up period was 21.55 months. The average VAS improved from 8.2 to 1.95 and the average DASH score improved from 72.25 to 51.7. Moreover, 11 cases were satisfied (55%), 3 cases (15%) were satisfied with reservation and 6 cases (30%) were not satisfied. In the second group (treated by PRP), the average follow-up period was 18.47 months. The average VAS improved from 8.52 to 1.47, the DASH score improved from 72 to 48.23. Concerning patient satisfaction, 13 cases were satisfied (83.33%), 3 cases (10.52%) were satisfied with reservation and 1 case (5.55%) was not satisfied. Conclusion: Platelet rich plasma was proved to achieve superior results when compared to ESWT as regards pain relief, improvement of elbow function and patient satisfaction at follow-up.
文摘External humeral epicondylitis, also known as brachioradial bursitis, popularly called “tennis elbow” refers to the acute or chronic myofascitis, the injury of the common extensor tendon of the humeral epicondyle. The authors have recently treated 62 cases of the disease by means of stiletto needle, the therapeutic effect of the treatment is so satisfactory, following is the report of the treatment.
文摘Objective To observe the clinical effects of wrist-ankle acupuncture on external humeral epicondylitis. Methods Seventy-two cases diagnosed as external humeral epicondylitis were brought into the study. Horizontal needling was used at upper area 3, upper area 4 and upper area 5 near wrists with long filiform needles. The frequency was once a day, and a course included 10 times. Results 27 cases got cured, 36 cases were marked effective, 5 cases were effective and 4 cases were failed after 1 course to 5 courses of treatment. The total effective rate was 94.5%. Conclusion Wrist-ankle acupuncture is a simple and effective therapy on external humeral epicondylitis.
基金National Natural Science Foundation of China:81774402。
文摘Objective:To observe the clinical effect of electroacupuncture(EA)at Zhouling(Extra)and Ashi points in combination with blood-letting cupping for the treatment of external humeral epicondylitis(EHE).Methods:Thirty EHE patients were treated with EA at Zhouling(Extra)and Ashi points in combination with blood-letting cupping,once every 2 days,twice a week,4 times as one course of treatment,and2 successive courses of treatment were given.Before treatment,after 1 course of treatment,and after 2 courses of treatment,the visual analogue scale(VAS)score and Mayo elbow performance score(MEPS)were adopted to evaluate the curative effect.Results:Before treatment,the VAS score of patients was 7.81±1.39.After 1 course of treatment and after 2 courses of treatment,it was 4.77±1.56 and 2.95±1.23 respectively,lowered than before treatment,and the difference was statistically significant(both P<0.01).Before treatment,the Mayo score of patients was 32.17±19.31.After 1 course of treatment and after 2 courses of treatment,it was 47.39±19.85 and85.21±20.47 respectively,increased than before treatment,and the difference was statistically significant(both P<0.01).Of the 30 patients,5 were cured,accounting for 16.67%;14 cases obviously effective,accounting for 46.67%;8 cases effective,accounting for 26.67%;3 cases ineffective,accounting for 10.00%,and the total effective rate was 90.00%.Conclusion:EA at Zhouling(Extra)and Ashi points and blood-letting cupping used in combination are remarkably effective in the treatment of EHE,being worthy for popularization.
基金Supported by the Chang Gung Memorial Hospital Research Project(No.CMRPG890781)
文摘Lateral epicondylitis （LE） is a common musculoskeletal problem. The incidence is estimated to be 0.4%-0.7% per year in general practice, and between 1% and 3% per year in the adult general populationJ2） LE results from repetitive micro-trauma by overuse of the wrist extensor musculature, which ultimately leads to failure of the common extensor tendon,
文摘目的:肱骨髁上骨折是儿童肘部骨折中最常见的类型,对于移位的肱骨髁上骨折,闭合复位固定是首选的治疗方案,但是对于选择合适的技术仍存在分歧。因而,此次荟萃分析旨在评估单侧和双侧交叉钉固定对儿童肱骨髁上骨折的疗效,为临床治疗提供参考。方法:全面检索PubMed、Embase、Web of Science和the Cochrane Library建库以来至2023-01-06发表的相关随机对照试验,比较儿童肱骨髁上骨折内外侧交叉固定和单纯外侧固定两种术式的疗效差异,主要观察指标是影像学结果(Baumann角丢失、提携角丢失)、肘关节功能和常见并发症(医源性尺神经损伤、针道感染)。结果:①共纳入18项研究;②两组Baumann角丢失(P=0.47)、提携角丢失(P=0.47)情况相比无统计学差异;外侧固定组与内外侧交叉固定组关节功能恢复评分优秀的患儿比例分别为70.7%和74.9%,差异无显著性意义(P=0.12);两组在针道感染发生率上同样无统计学差异(P=0.9),但内外侧交叉固定组医源性尺神经损伤的风险更高(P=0.02);③然而,当采用小切口联合探查时,内外侧交叉固定组尺神经损伤的频率与外侧固定组相比无统计学差异(P=0.2);④在GartlandⅢ型亚组中,两组在关节功能恢复评分优秀率(P=0.13)、尺神经损伤(P=0.13)和针道感染(P=0.61)方面均无统计学差异。结论:荟萃分析结果显示,与外侧固定技术相比,内外侧交叉固定方法更容易造成前臂的医源性神经损伤,但同时也增加了结构的稳定性。不过,通过小切口方法联合内外侧交叉固定似乎可以降低患者神经损伤的风险。因此,儿童肱骨髁上骨折治疗采用小切口结合内外侧交叉固定可能是一种既保证结构稳定、又安全的固定方法。
文摘Lateral elbow tendinopathy(LET) is a common musculoskeletal/sports injury. A plethora of physiotherapy techniques has been proposed in the management of LET. The exercise programme is the most common treatment in the management of LET. The optimal protocol of exercise programme is still unknown. The effectiveness of the exercise programme is low when it is applied as monotherapy. Therefore, exercise programme is combined with other physiotherapy modalities such as soft tissue techniques, external support, acupuncture, manual therapy and electrotherapy, in the treatment of LET. Future research is needed to determine which treatment strategy combined with exercise programme will provide the best results in LET rehabilitation.
文摘Lateral elbow tendinopathy(LET) is one of the two most common tendinopathies of the upper limb. The most effective treatment in the management of LET is the exercise program. Clinicians combine exercise program with other physiotherapy, electrotherapeutic and no, techniques. Extracorporeal shock wave therapy(ESWT) is one of the most common recommended electrotherapeutic modalities for the management of LET. Further research is needed to find out the optimal treatment protocol of ESWT in the management of
文摘BACKGROUND Coronal shear fractures of the distal humerus are rare injuries and are technically challenging to manage.Open reduction and internal fixation(ORIF)has become the preferred treatment because it provides anatomical reduction,stable internal fixation,and early motion,but the optimal surgical approach remains controversial.CASE SUMMARY We report three cases of coronal shear fractures of the distal humerus treated successfully by ORIF via a novel surgical approach,in which lateral epicondyle osteotomy was performed based on the extended lateral approach.We named the novel surgical approach the lateral epicondyle osteotomy approach.All patients underwent surgical treatment and were discharged successfully.All patients had excellent functional results according to the Mayo elbow performance score.The average range of motion was 118°in flexion/extension and 172°in pronation/supination.Only case 2 had a complication,which was implant prolapse.CONCLUSION We demonstrated that the lateral epicondyle osteotomy approach in ORIF is effective and safe for coronal shear fractures of the distal humerus.
文摘目的观察郑氏手法治疗肱骨外上髁炎的治疗效果。方法将2021年8月—2022年1月该院筋伤科门诊收治的60例肱骨外上髁炎病人按照纳入顺序用随机数字表随机分类法随机分成两组,每组30例,治疗组30例病人予郑氏手法治疗,对照组30例病人予局部封闭治疗,两组疗程均是2周。疗程结束后评估两组总体疗效,治疗前后视觉模拟评分法(visual analog scale,VAS)评分,治疗前后Mayo肘关节功能评分,治疗前后美国特种外科医院(Hospital for Special Surgery,HSS)肘关节功能评分,治疗前后肘关节局部压痛阈值。结果治疗组的总有效率为88.89%(24/27),优于对照组总有效率81.48%(22/27)(P<0.05);两组治疗后VAS评分均降低,两组差异无统计学意义(P>0.05);两组治疗后Mayo肘关节评分和HSS肘关节评分均增高,治疗组评分明显高于封闭组(P<0.05);两组治疗后Mayo肘关节评分和HSS肘关节评分均增高,治疗组评分明显高于封闭组(P<0.05);两组治疗后肘关节局部压痛阈值较治疗前均有提升,治疗组肘关节局部压痛阈值明显高于封闭组(P<0.05)。结论郑氏手法治疗肱骨外上髁炎疗效优于局部封闭治疗,值得临床推广应用。
文摘目的观察石墨烯新型灸贴与活络止痛贴治疗肱骨外上髁炎的疗效差异,探讨石墨烯新型灸贴的有效性。方法按照随机数字表法将72例肱骨外上髁炎的患者平均分到试验组和对照组,试验组采用石墨烯新型灸贴,对照组采用活络止痛贴,2组均选取患侧的阿是穴(最痛点)、曲池和手三里,每穴1贴,隔日贴敷1次,每次贴敷6 h,2组均治疗14 d。分别对比治疗前后的视觉模拟评分(Visual Analogue Scale,VAS)、上肢功能评定量表评分(Disability of Arm Shoulder and Hand,DASH)及无痛握力值(Pain-free Grip Strength,PFG)。结果2组患者的VAS评分和DASH评分均降低(P<0.05),PFG值较治疗前增高(P<0.01)。组间比较发现,试验组总有效率为93.90%;对照组总有效率为88.20%。结论石墨烯新型灸贴治疗肱骨外上髁炎的疗效优于活络止痛贴。
文摘目的:探讨理筋拔戳揉捻法治疗肱骨外上髁炎(liater epicondylitis,LE)的临床疗效。方法:自2018年1月至2021年12月采用多中心随机对照研究方法,分别在中国中医科学院望京医院、北京电力医院、北京丰盛骨伤科专科医院收集LE患者192例,采用随机数字表法分为治疗组和对照组。治疗组96例,男36例,女60例;年龄28~60(41.20±5.50)岁;病程1~14(5.24±1.35)d;予理筋拔戳揉捻法配合肘关节练功法治疗,隔日1次,治疗2周。对照组96例,男33例,女63例;年龄26~60(43.35±7.75)岁;病程1~14(5.86±1.48)d,予外用扶他林配合护肘关节固定治疗,治疗2周。分别于治疗前及治疗后第1、3、5、7、11、13天比较疼痛视觉模拟评分(visual analogue scale VAS)、美国特种医院评分系统(Hospital for Surgery Scoring System,HSS)、肘关节旋前及旋后角度、腕关节掌屈及背伸角度、肘关节压痛,并比较治疗前及治疗结束后美国特种医院评分系统2(Hospital for Surgery Scoring System2,HSS2)肘关节评分。结果:所有患者获得随访,时间10~14(12.0±1.6)d。治疗组及对照组治疗前VAS分别为(6.83±1.36)、(6.79±1.58)分,末次治疗后降低至(1.49±1.09)、(2.11±1.81)分,其中治疗后第1、3、5、7、9、11、13天,治疗组VAS较对照组明显降低(P<0.05)。两组治疗前HSS评分分别为(61.73±11.00)、(36.47±12.45)分,末次治疗后提高至(94.42±5.90)、(91.44±9.11)分,其中治疗后第1、3、5、7、9、11、13天,治疗组HSS显著高于对照组(P<0.05)。治疗后第5天,治疗组肘关节外旋角度、内旋角度分别为(66.41±12.69)°、(66.35±13.54)°,对照组为(62.08±16.03)°、(61.77±16.35)°;治疗后第7天,治疗组肘关节外旋角度、内旋角度分别为(69.79±12.64)°、(70.02±13.55)°,对照组为(65.28±15.86)°、(65.09±16.67)°,以上时间点治疗组肘关节活动度大于对照组(P<0.05)。治疗后第5天,治疗组腕关节背伸、掌屈角度为(39.43±15.94)°、(46.68±11.10)°,对照组为(38.51±18.49)°、(44.27±13.58)°;治疗后第7天,治疗组腕关节背伸、掌屈角度分别为(42.52±16.50)°、(49.23±10.96)°,对照组为(41.18±20.09)°、(46.64±14.63)°;治疗组腕关节活动度大于对照组(P<0.05)。治疗后第13天,治疗组HSS2为(93.61±6.32)分,高于对照组(92.06±7.94)分(P<0.05)。两组各时间点肘关节压痛值比较,差异无统计学意义(P>0.05)。结论:扶他林外用联合肘部固定和理筋拔戳揉捻手法均能有效改善LE的症状,理筋拔戳揉捻手法较扶他林外用治疗具有止痛时间长和恢复肘关节功能更好的优势。
文摘目的探讨基于灶点理论的弧刃针疗法治疗顽固性网球肘的临床疗效。方法收集64例顽固性网球肘患者,采用随机数字表法分为对照组和观察组。其中对照组32例,采用局部痛点注射治疗。观察组32例,采用弧刃针疗法治疗,每周治疗1次,均治疗2次,分别记录并比较两组患者治疗前、治疗后1、2、4及24周随访的疼痛数字评分(numberal rating scale,NRS)、肘关节功能评分(Mayo elbow perfor⁃mance score,MEPS)、肩臂手残障(disabilities of the arm,shoulder and hand,DASH)评分以及24周随访时的疾病的疗效评分(Wangxuechang diease efficacy score,WDES)。结果治疗过程中两组患者均未见不良事件发生。两组患者治疗前的NRS、MEPS及DASH差异均无统计学意义(P>0.05);治疗后各时期,两组NRS、MEPS、DASH及24周随访时的WDES较治疗前均改善,治疗1周后,两组NRS差异无统计学意义(P>0.05),治疗2、4及24周随访时的NRS观察组低于对照组;治疗后1、2、4及24周随访时,观察组DASH评分低于对照组,MEPS评分高于对照组,差异有统计学意义(P<0.05),治疗24周后随访时的WDES,观察组优于对照组,差异有统计学意义(P<0.05)。结论局部痛点注射及弧刃针灶点松解治疗顽固性网球肘早期均能缓解疼痛,改善肘关节功能,而局部痛点注射治疗后远期效果欠佳,观察组治疗效果逐渐提升。
