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small needle-knife plus injection therapy efficacy Supracondylar inflammation. [Methods] In supracondylar first trigger point injection, and then use a small needle-knife to loosen. [Results] 31 cases of supracondylar spondylitis patients treated total efficiency 96%. [Conclusion] plus local injection with a small needle-knife is currently on the inflammatory efficacy of treatment of humeral condylar better way.
Keywords: supracondylar inflammatory efficacy of small needle-knife point injection
Supracondylar humerus bone inflammation is more common out-patient of a disease. Using traditional treatment methods tend to bear fruit slowly, so that patients disappointment. Although the treatment with the partial closure of the quick, but not long-term maintenance of efficacy, and easy-to-recurrence, the author from February 2006 to June 2008, with a small needle-knife plus injection Supracondylar inflammation in 31 patients, received more satisfactory outcome, are reported as follows.
A clinical data
1.1 The diagnostic criteria of this disease particularly prevalent in the forearm and the labor intensity involved in a larger staff, such as the housewife. Most of the slow onset, showing the elbow, or lateral epicondyle medial epicondyle at pain, ipsilateral hand feel powerless, forced pain from time to time. Physical examination, the humeral epicondyle, and brachioradialis on the condyles within the joint space or the Department has a clear point of tenderness. The case of epicondylitis extensor tendon traction test was positive (Mill sign). Patients Department did not swollen or slightly swollen, color is not red, skin temperature is not high, elbow flexion and extension function of unrestricted elbow more than conventional X-ray examination found no positive signs.
1.2 Exclusion criteria suffering from malignant tumors, rheumatoid arthritis, serious heart disease, hypertension, diabetes and skin infections other than local.
1.3 General Information 31 patients were outpatients, 15 patients were male, female 16 cases, the oldest 65 years old, minimum 35 years old, with an average 47 years old, the medial epicondyle pain in 5 cases, lateral epicondyle pain in 24 cases, both inside and outside the condyle were pain in 2 cases, the right side of 25 cases, left in 6 cases, a simple pain in 28 cases of supracondylar, accompanied by two cases of cervical spondylosis, associated with old avulsion fracture in 1 case.
Two treatment
2.1 Injection 2% lidocaine hydrochloride preparation needle 2ml, vitamin B12 needle 1ml, triamcinolone acetonide acetate needle 0.5ml (20mg), sterile saline solution increased to 5ml, spare.
2.2 The case of small needle-knife therapy
① postural lateral epicondyle of humerus, the patient sitting or supine position can be used straight 135-degree elbow forearm pronation position, in the case within the condyle, the patient with supine position, elbow straight and forearm supination position;
② fixed-point, in the lateral or medial epicondyle epicondyle tenderness most prominent at good indentation marks.
③ disinfection, local skin with 2% povidone-iodine tampons from the tag center to the surrounding spiral started, and then 75% alcohol cotton ball from the center outwards off iodine, and then doctors wear sterile masks, sterile gloves, prepare hero Brand-I chapter 4, a small sterile needle-knife.
④ trigger point injection, the doctor left thumb holding down the painful area, slightly pressurized separation of his right hand holding a pre-injection preparation of a good alignment pain point injections.
⑤ needle lysis, the doctor left thumb hold the original position without moving his right hand holding a good little knife and a small needle-knife in accordance with the Han Zhang needle four-step [1] into the needle, according to longitudinal incision decomposition adhesion, cis forearm extensor muscle or the flexor tendon axis for 2 ~ 3 linear lysis. ⑥ bandage, small needle-knife loosen after a needle, pinhole Department paste with sterile bandage, and oppression around 3/min to prevent bleeding, the last few laps with gauze bandage to prevent the Band-Aid off.
2.3 The course of treatment in patients with 1 week treatment 1 times, each time after conventional oral anti-inflammatory, analgesic medicine 3d, to prevent the needle mouth infections, and Zhu Huanzhe after 1 week rest for 3 times as a course of treatment.
3 Treatment outcome
3.1 Clinical Standards markedly: The cure for the pain disappeared after supracondylar humerus, working to do things without discomfort. Effective: After treatment, supracondylar humerus pain, do heavy work, the affected area is still unwell, with a break can ease. Improved: After treatment, supracondylar humerus pain alleviated, but a little tired after the pain reappeared. Invalid: After treatment, symptoms and signs of little change.
3.2 The results of 31 patients treated by the out-patient cure, only two cases of consecutive made 3 times to complete a course of treatment, the rest is only cure for a ~ 2 times the suspension. 30 cases with 1 ~ June Telephone Interview, 1 patient lost telephone contact with the results of 12 cases markedly effective in 12 cases, improvement in 6 cases, ineffective in 1 case, efficiency 96%.
4 Discussion
Supracondylar inflammation and inner exceptionally epicondylitis epicondylitis. Epicondylitis also known as tennis elbow because tennis players more common name of the Guer, which is the forearm extensor tendons in the only point of the Ministry of the total chronic traction injury to lateral elbow pain caused by disease, a syndrome-based.
Epicondylitis is the forearm in flexion and extension button at the only point of the Ministry of the total chronic traction injury caused to the medial epicondyle medial elbow pain in the main card of a syndrome caused by inflammation of the reasons for supracondylar common is the manual the crowd repeated the long-term labor-intensive force of the forearm, flexion and extension activities to be repeated over-tendon stretch and wear, resulting in a torn muscle fiber bundles, resulting in edema, hemorrhage, hematoma machine-based, fiber hyperplasia, scar tissue formation and other changes, thus stimulate local nerve endings, resulting in compression and adhesion, causing pain traction.
Diagnosis of the disease according to the typical medical history, tenderness supracondylar area, local non-swollen or slightly swollen, skin color is not red, skin temperature is not high, the elbow is lateral view to exclude organic disease can be diagnosed. Separation of this Act the use of small needle-knife adhesion, and clear the block, flowing blood, shaving scars, loosen muscles, analgesic pain
②. So that adhesion of tendon supracondylar area, fascia can be broken down to be releasable to suppress the nerve endings; the same time, the use of local anesthesia with lidocaine needles are conducive to the full loosen needle knife, vitamin B12 nutritional role of nerve tissue, acetic acid Qu acetonide needle has anti-inflammatory, preventing re-adhesion of the role of the organization.
The combination treatment of inflammation has the effect of Supracondylar quick and accurate, that is generally a sub-therapeutic effects of small needle-knife during the operation must pay attention to sterile concept, lysis which must be "light, accurate, and stable" Enough is enough. The last thing to point out is supracondylar inflammation is a closely related strain and occupational disease, regardless of what kind of treatment, and upon recovery, we need to remove the original injury risk factors, so that will consolidate the curative effect.
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