Accessibility View
Skip Header
Skip Content
Home / Specialties / Elbow / Common Extensor Tendon Origin Repair
Inicio / Especialidades / Codo / Reparación del Origen del Tendón Extensor Común

Common Extensor Tendon Origin Repair

The common extensor tendon is a tough band of fibrous connective tissue that attaches to the lateral epicondyle of the humerus (long bone in the upper arm) at the elbow. Rupture or tear of the common extensor tendon is the most common acute tendon injury of the elbow. The most frequent pathology of the common extensor tendon is epicondylitis and is characterized by loss of normal tendon structure.

A surgical or conservative approach is employed to treat injuries of the common extensor tendon origin such as Tennis elbow/lateral epicondylitis. Tennis elbow and golfer’s elbow are similar, except that golfer’s elbow occurs on the inside of the elbow (medial epicondylitis) and tennis elbow occurs on the outside of the elbow (lateral epicondylitis). Tennis elbow is an overuse injury of the common extensor tendon origin. The common extensor tendon originating from the lateral epicondyle of the elbow is directly involved in Tennis elbow.

Causes of Common Extensor Tendon Origin Rupture

Any recreational or occupational activity that involves extensive use of the common extensor tendon can result in tennis elbow or lateral epicondylitis. It is commonly seen in individuals between the ages of 30 and 50. Common causes may include:

  • Activity that requires repetitive motion of the forearm such as painting, typing, weaving, gardening, lifting heavy objects, and sports.
  • Overuse of the forearm muscles.
  • Direct trauma as with a fall, work injury, or motor vehicle accident.
  • Poor grip when playing racket sports.
  • Weakened muscles of the shoulder and wrist.

Symptoms of Common Extensor Tendon Origin Rupture

Signs and symptoms of common extensor origin rupture may include:

  • Elbow pain that gradually worsens
  • Pain at the outside of the elbow that radiates to the forearm and wrist when grasping objects
  • Weak grip
  • Painful grip
  • Exacerbated pain in the elbow when the wrist is bent back

Diagnosis of Common Extensor Tendon Origin Rupture

Your doctor will evaluate the rupture by reviewing your medical and occupational history, performing a thorough physical examination, and ordering X-rays, MRI or electromyogram (EMG) to rule out any fracture, soft tissue injury, or other disease conditions.

Procedure for Common Extensor Tendon Origin Repair

If conservative treatment options fail to resolve the condition and symptoms persist for 6-12 months, your surgeon may recommend a surgical procedure called lateral epicondyle release surgery. Your surgeon will decide whether to perform your surgery in the traditional open manner (single large incision) or endoscopically (2 to 3 tiny incisions and the use of an endoscope – narrow lighted tube with a camera). Your surgeon will decide which option is best for you depending on your specific circumstances.

Surgery will be performed under general anesthesia. Your surgeon makes a small incision over the midpoint of the lateral epicondyle to disclose the common extensor tendon origin. In order to protect the radial nerve, the elbow will be flexed. Your surgeon will move aside soft tissues to view the common extensor tendon and its attachment on the lateral epicondyle and then trims or releases the tendon and reattaches it to the bone. Any scar tissue present will be removed as well as any bone spurs. After the surgery is completed, the incision(s) are closed by suturing or by tape.

Postoperative Care

Common post-operative care guidelines include:

  • Elevate the arm above chest level to reduce swelling.
  • A brace or splint may be worn keeping the elbow at a 90-degree angle with early motion initiated in the first week.
  • Ice packs may be applied to the surgical area to reduce swelling.
  • Keep the surgical incision clean and dry. Cover the area with plastic wrap when bathing or showering.
  • Physical therapy is recommended for strengthening the muscles and to restore normal range of motion.
  • Eat a healthy diet and refrain from smoking to promote faster healing.

Risks and Complications of Common Extensor Tendon Origin Repair

As with any major surgery, common extensor tendon origin repair may involve certain risks and complications, such as:

  • Allergic reactions to medications
  • Blood loss
  • Infection
  • Nerve damage
  • Radial nerve damage, causing numbness, tingling, burning or loss of feeling in the back of the hand and forearm
  • Wrist weakness with extension
  • Recurrence or failure of relief from symptoms

Reparación del Origen del Tendón Extensor Común

El tendón extensor común es una banda dura de tejido conectivo fibroso que se adhiere al epicóndilo lateral del húmero en el codo. La ruptura o desgarro de este tendón es la lesión aguda más común del codo. La patología más frecuente es la epicondilitis, caracterizada por pérdida de la estructura normal del tendón.

Se emplea un enfoque quirúrgico o conservador para tratar lesiones del origen del tendón extensor común, como codo de tenista/epicondilitis lateral. El codo de tenista ocurre en el exterior del codo (epicondilitis lateral) y el codo de golfista en el interior (epicondilitis medial).

Causas

  • Actividades que requieren movimiento repetitivo del antebrazo: pintura, mecanografía, tejido, jardinería, levantar objetos pesados, deportes
  • Sobreuso de los músculos del antebrazo
  • Trauma directo: caídas, accidentes laborales o de tránsito
  • Mal agarre en deportes de raqueta
  • Músculos debilitados del hombro y muñeca

Síntomas

  • Dolor en el codo que empeora gradualmente
  • Dolor en el exterior del codo que se irradia al antebrazo y muñeca
  • Agarre débil y doloroso
  • Dolor aumentado al doblar la muñeca hacia atrás

Diagnóstico

Historia médica y ocupacional, examen físico, radiografía, MRI o electromiografía para descartar fracturas o lesiones de tejidos blandos

Procedimiento Quirúrgico

Si los tratamientos conservadores fallan después de 6-12 meses, se puede recomendar cirugía de liberación del epicóndilo lateral. Puede realizarse de forma abierta o endoscópica según el caso.

  • Anestesia general
  • Incisión sobre el epicóndilo lateral para exponer el tendón extensor común
  • Protección del nervio radial, flexión del codo
  • Mover tejidos blandos, recortar o liberar el tendón, reanexar al hueso
  • Remoción de tejido cicatricial y espolones óseos
  • Cierre de incisión con suturas o cinta

Cuidados Postoperatorios

  • Elevación del brazo para reducir hinchazón
  • Férula o cabestrillo con codo a 90°; movilidad temprana desde la primera semana
  • Hielo en área quirúrgica
  • Mantener incisión limpia y seca
  • Fisioterapia para fortalecer músculos y restaurar rango de movimiento
  • Dieta saludable y evitar fumar

Riesgos y Complicaciones

  • Reacciones alérgicas a medicamentos
  • Pérdida de sangre
  • Infección
  • Daño nervioso, especialmente al nervio radial
  • Debilidad de la muñeca
  • Recurrencia o falla en el alivio de síntomas