| *** Live Surgery Video *** |
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| What is it? |
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| This is a condition where a group of tendons which normally moves the wrist and elbow become painful because of friction at the elbow. The first symptom of this is usually pain at the outside of the elbow which is worse with use of the elbow or wrist, and hurts a lot when the elbow accidentally hits something. It can cause swelling or even a knot on the elbow which really impair the use of the elbow and whole arm. |
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| What causes it? |
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| It is caused by inflammation (often from long-term overuse) of the tendons at or near where they attach to to bone in the elbow. This inflammation results in an enlarged and damaged tendon, and this is what causes the increased friction and pain. |
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| Will it get worse? |
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| It is possible for it to just go away, but if there is swelling or a knot, it is not likely to heal on its own. It is also not likely to go away if it has been present for several months, which indicates tendon damage is occurring. It will often progress and impair function of the whole arm because of pain and a feeling of weakness. |
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| What is the treatment? |
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| Bracing, elbow straps, and therapy are quite effective for this condition. Medicines like aspirin, Tylenol, Motrin and other anti-inflammatories may help with the symptoms. An injection given near the tendon by your doctor can often resolve this problem. Sometimes 2 or even 3 injections might be necessary. Surgery is very effective for this condition. |
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| Do I need surgery? |
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| Most patients do not need surgery for this, as most respond well to medicines and injections. But, if the condition persists, surgery is an effective option. |
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sketch of arthroscopic view of the joint and tendon to be released, the Extensor Carpi Radialis Brevis |
| What type of surgery are we talking about? |
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| If injections, bracing and medicines don't work, surgery may be recommended. It is an outpatient surgery, meaning you go home the same day as surgery. It takes about 30 minutes, and is done arthroscopically, meaning very small incisions and very little tissue damage, so recovery is faster than other methods. After the surgeon incises the skin, the tendon that causes the pain is identified and damaged tissue is released and removed. Usually, the excess bone is smoothed out, and the elbow joint is inspected. This procedure has no appreciable adverse effect on the use of the elbow or wrist. A high percentage of patients have resolution of the problem after surgery, and there are very few complications, making this a very safe and effective procedure. |
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Actual surgical arthroscopic views of release of the extensor tendon |
| Is surgery safe? |
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| Your surgeon will discuss the risks with you, but it is a very safe and effective procedure. |
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| How long would I be out of my job after surgery? |
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| You will be sent home with a splint (brace) on your arm. You should move your fingers the day of surgery, as this helps prevent and reduce swelling and stiffness. The stitches are removed in the office in about than 1-2 weeks. Jobs with clerical or light-type of work can be resumed within 1-2 weeks, heavier duty-type jobs such as manual labor can be done after 4-6 weeks in most cases. Many people have returned to their jobs the day after surgery - it really depends on the job type more than anything. |
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