Mini-Open Surgical Management of Tennis Elbow Pathology

While most patients respond to non- operative management of lateral epicondylitis (tennis elbow), chronic symptoms develop in a small percentage. Surgical treatment is considered in patients with persistent pain, failure to respond to a quality rehabilitation protocol, and an unacceptable quality of life. Historically, surgical interventions were dedicated to releasing the extensor digitorum communis (EDC) origin or a slide of the extensor aponeurosis. We describe the rationale and long term results of the Nirschl "tennis elbow" surgical approach which includes debridement of the extensor carpi radialis brevis ( ECRB) and repair of the ECRL to the EDC. These results are compared to other methods and the rationale for current treatment methods are discussed. The techniques for addressing medial "tennis elbow" and triceps tendinosis are also described as well as the techniques and rationale for surgical treatment in salvage situations.