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Orthopaedic Surgery

Contact

Spire Yale (Private Only)
Anna Gizzi
01978 268 065

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Robert Jones and Agnes Hunt Orthopaedic Hospital (RJAH), Oswestry (private and nhs)
Hayley Higgins
01691 404 099

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Wrexham maelor (NHS Only)
Anne fisher
01978 725720

Tennis Elbow

The condition is also known as lateral epicondylitis although the condition is degenerative not inflammatory.

Symptoms include pain and tenderness on the outer part of the elbow made worse by gripping especially with movements of the wrist.

The diagnosis is made by clinical signs and symptoms, however if the clinical picture is not straightforward an MRI scan may be performed.

Treatment

About 80% of patients can be treated conservatively with stretches, bracing, friction or ultrasound icing and simple analgesia.

Surgery is reserved for cases not responding to simple treatment and is a simple day case general anaesthetic percutaneous release of the extensor tendons at the elbow, although it is essential to rest the elbow from lifting and sport for a minimum of 4 weeks post operatively.

Ulnar nerve entrapment

Cubital tunnel syndrome, occurs when the ulnar nerve is obstructed at the elbow. This compression of the nerve often leads to a tingling or 'pins and needles' sensation in the little and ring fingers. Most cases will be minor and tend to come and go with time. However if the compression progresses with time the small muscles of the hand become weak so grip and fine complex movements of the hand become difficult.

Occassionaly the ulnar nerve can become compressed at the wrist with a similar clinical picture.

Early diagnosis is important with nerve conduction studies telling us if the nerve is just "irritable" or if the nerve itself has started to deteriorate.

If nerve function tests are normal, neural stretching exercises, splintage and analgesia may suffice. If the nerve itself is being damaged then surgery to release the nerve should be performed before symptoms become too severe. Once muscles have weakened this change is irreversible and treatment too late.