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网球肘松解术

Tennis elbow release surgery — for persistent pain despite physiotherapy and other conservative treatments.

Updated Aug 2026

一幅手绘插图，描绘了一个无脸的人紧握网球拍。 — 网球肘：伸肌腱在其附着于肱骨外上髁（肘部外侧的骨性突起）处发生退变。释放手术会切除受损的肌腱组织。 Kieran Hirpara 4.0

为何建议进行此手术¶

本页面反映了罗克汉普顿 Mater 私人医院上肢外科医生 Kieran Hirpara 博士在门诊中对此类情况的处理方式。网球肘松解术是一种旨在缓解肘部疼痛并改善功能的手术。我们通常仅在非手术治疗未能带来足够改善后才向您推荐此手术。大多数患者无需手术即可在 12 至 18 个月内康复。约 90% 未经治疗的网球肘患者在 1 年内可实现症状缓解。症状的半衰期稳定为三至四个月。病程较长并不意味着预后较差。

当保守治疗失败且疼痛持续存在时，我们会考虑手术。对于极少数对非手术方法无反应的患者，手术满意度接近 90%。本手术旨在减轻疼痛并恢复您使用手臂的能力。当手术益处超过该疾病的自然病程时，我们推荐进行此手术。您的康复取决于您的具体症状以及对先前治疗的反应。

手术前¶

您的外科医生将安排必要的检查，如X光或血液检查，以确保您适合手术。请在手术前一晚午夜开始禁食。仅在您的外科医生给出具体指示后，才停止服用抗凝药物。安排专人开车送您回家，并在第一晚陪伴您。就诊时请穿着宽松、舒适的衣物。请携带当前所有药物和补充剂的完整清单。该开放手术将在肘部做一个切口。我们将引导您完成每一步，确保您的安全并让您充分了解情况。

手术当天¶

本手术在全麻下进行。您将在手术过程中完全入睡。部分患者可能还会接受区域神经阻滞以缓解术后疼痛——麻醉医生会根据您的具体情况在手术当天决定。

您需到医院办理入院手续。您将见到麻醉医生，讨论您的护理方案。您的外科医生将通过开放入路进行手术，在手术部位做一个常规的单一切口。随后您将进入手术室。手术结束后，您将在复苏室苏醒。我们的团队将在您从麻醉中恢复期间密切监测您的情况。

手术内容¶

您的外科医生将通过肘部外侧的一个常规切口进行此手术。这种开放入路可直接到达受累肌腱，无需进行多个小切口或借助摄像头。

手术期间，您的外科医生会仔细识别桡侧腕短伸肌腱，这是引起您疼痛的组织。外科医生使用精密器械切除该肌腱附着点中受损和退变的部分。外科医生还会清理并准备下方的骨面（即肱骨外上髁），以促进健康愈合。此过程可释放肌腱张力并消除刺激源。

一旦移除受损组织并准备好骨面，您的外科医生将使用缝线或钉合器缝合切口。随后施加无菌敷料以保护手术部位。整个手术旨在纠正肘部的结构性问题，以缓解疼痛并恢复功能。

术后¶

您将在复苏室苏醒，手臂佩戴吊带并覆盖软性敷料。我们使用常规药物进行疼痛管理。该手术通常为日间手术，您预计当天即可出院，但偶尔患者需留院过夜。术后24小时内需有人陪同。您的主刀医生采用开放入路进行手术，在手术部位做单一常规切口。通常在疼痛缓解至足以握持方向盘并快速反应后，您可在2至3周内恢复驾驶。手臂佩戴吊带期间请勿驾驶。详见上肢手术后驾驶。

恢复¶

在最初几天，您会注意到一些肿胀和僵硬。这是正常的。我们通过简单的止痛和休息来使不适感保持在可接受范围内。您的手臂可能会感觉沉重，或切口周围有压痛。随着初期肿胀消退，这种情况通常会缓解。我们建议尽可能抬高患肢，以帮助减少液体积聚。

手术部位会覆盖软性敷料，并在最初一周左右使用吊带以提供舒适；肘部不会用石膏或夹板固定。我们不建议在手臂佩戴吊带期间驾驶。通常在两到三周后，当疼痛减轻到足以握住方向盘并快速反应时，您通常可以恢复驾驶。更多详情，请参阅上肢手术后的驾驶。

您的康复由我们的团队指导。术后手部治疗由 Extend Rehabilitation 的 Ruby Doolan 负责。她将指导您进行轻柔的活动以恢复关节活动度。您将从家中的轻度活动开始，例如抓握柔软物体。随着活动能力恢复，您将逐渐增加力量。除了肘部外，我们还会关注上肢近端节段，以确保完全康复。

您的恢复时间表可能有所不同；您的外科医生和物理治疗师将为您提供指导。我们会密切监测您的进展，以确保您愈合良好。当日常任务变得更容易且疼痛减轻时，您就会知道自己在好转。相信康复过程并遵循我们的建议，以获得最佳效果。

可能出现的并发症¶

大多数患者恢复良好，但偶尔也会出现一些问题。您的外科医生和医疗团队会密切监测您的情况，以便尽早发现任何问题。

症状持续存在的可能性。您可能会发现肘部外侧的疼痛没有消失，或者在您认为已经痊愈后再次出现。这可能在抓握物体时表现为钝痛或锐痛。如果您的症状没有改善，请联系诊所讨论您的恢复情况。

任何手术都存在感染风险。您可能会看到伤口周围出现红肿扩散。该区域触摸时可能感觉发热或看起来肿胀。您还可能出现发烧。如果您注意到这些迹象，请立即致电诊所或前往急诊科。

活动度可能出现轻微受限。您可能会发现完全伸直或弯曲肘部比以前更困难。这在移动手臂时可能表现为紧绷感或物理性阻挡。请在下次复诊时提出此问题，以便我们调整您的康复计划。

异位骨化是一种罕见的疾病，指骨骼在关节周围的软组织中形成。您可能会在肘部附近的皮肤下摸到硬块。这可能会限制活动并引起不适。请向您的外科医生报告任何新出现的肿块或活动能力的显著变化。

极少需要进行翻修手术。需要进一步手术的可能性非常低。然而，在手术前接受三次或更多次注射会增加这种风险。如果您接受过多次注射，请注意您的外科医生可能会在咨询期间与您讨论此情况。

如果您想了解具体数据，本页的并发症表格列出了典型的发生率。

何时联系我们¶

如果您出现发热、伤口红肿或分泌物增加、突发剧烈疼痛、小腿肿胀或呼吸困难、感觉丧失或肢体无法活动，请立即联系我们。若症状严重，请前往急诊。我们希望确保您的康复进程顺利进行。请及时联系我们的诊所，以便我们评估您的需求，并为您的愈合过程提供适当的支持。

Evidence & references

This is the clinical evidence summary written for health professionals. It is technical, and it lists the research this page was built from. You do not need to read it to understand your treatment or to make a decision about it.

Anatomy & Pathophysiology¶

The pathologic tissue in tennis elbow involves the undersurface of the extensor carpi radialis brevis tendon [1].
The origin of the extensor carpi radialis brevis is visualized during arthroscopic tennis elbow release [1].
Decortication of the lateral epicondyle and lateral epicondylar ridge is performed to address pathologic tendinous attachment [1].
Undersurface tears of the extensor carpi radialis brevis are a finding in tennis elbow release procedures [1].
Medial capsular injury may occur and allow excessive fluid extravasation during arthroscopic elbow procedures [1].
A 30-degree arthroscope is adequate to view around the corner for most of the arthroscopic tennis elbow release procedure [1].
A 70-degree arthroscope may be required in rare instances during arthroscopic tennis elbow release [1].
The proximal medial or superomedial portal is located approximately 2 cm proximal to the medial epicondyle and 1 cm anterior to the intermuscular septum [1].
The trocar and sheath for the proximal medial or superomedial portal are introduced anterior to the intermuscular septum [1].
The trocar is directed toward the radial head while maintaining contact with the anterior aspect of the humerus [1].
The superolateral portal is established with an 18-gauge needle through the lesion [1].
Debridement of the capsule and pathologic tendinous attachment of the extensor carpi radialis brevis is performed using a curet and motorized shaver [1].
Decortication of the lateral epicondyle can be done with an arthroscopic burr, handheld instruments, or electrocautery [1].

Treatment¶

Arthroscopic tennis elbow release is described as technique 52.39 [1].
The patient is placed prone on the operating table after intubation [1].
Two rolled towels are placed longitudinally under the patient's thorax [1].
All bony prominences are padded well [1].
The affected extremity is positioned with the ipsilateral shoulder abducted to 90 degrees [1].
The arm is supported with a precut foam holder [1].
Anatomic landmarks and portal sites are marked prior to the procedure [1].
The joint is distended with 20 to 30 mL of saline through an 18-gauge needle introduced through the direct lateral portal [1].
The proximal medial or superomedial portal is established approximately 2 cm proximal to the medial epicondyle and 1 cm anterior to the intermuscular septum [1].
The trocar and sheath are introduced anterior to the intermuscular septum [1].
Contact with the anterior aspect of the humerus is maintained at all times as the trocar is directed toward the radial head [1].
A 2.7-mm, 30-degree arthroscope is inserted into the joint to perform the diagnostic portion of the procedure [1].
The superolateral portal is established with an 18-gauge needle through the lesion after pathologic tissue is identified [1].
A full-radius resector is used to excise the capsule to identify the undersurface of the extensor carpi radialis brevis tendon [1].
The origin of the extensor carpi radialis brevis is viewed [1].
A curet and motorized shaver are used to debride the capsule and the pathologic tendinous attachment of the extensor carpi radialis brevis [1].
The lateral epicondyle is decorticated [1].
Decortication of the lateral epicondyle and lateral epicondylar ridge can be performed with an arthroscopic burr, handheld instruments, or electrocautery [1].
A 30-degree arthroscope is adequate to view around the corner for most of the procedure [1].
A 70-degree arthroscope may be required in rare instances [1].
Limited internal fixation can be accomplished with cannulated screws when medial capsular injury has not occurred [1].
The benefit of arthroscopy is outweighed by associated risks in more extensive fractures involving significant soft-tissue injuries [1].
One should be fully prepared to abort the procedure when visualization is poor or fluid extravasation is significant [1].

References¶

[1] Campbell S Operative Orthopaedics 4 Volume Set. ARTHROSCOPIC REPAIR OF POSTERIOR HUMERAL AVULSION OF THE GLENOHUMERAL LIGAMENT > ARTHROSCOPIC TENNIS ELBOW RELEASE.

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