Nash H Naam1, Hakim A Massoud. 1. Department of Plastic and Reconstructive Surgery, Southern Illinois University Medical School and Southern Illinois Hand Center, Effingham, IL 62401, USA.
Abstract
PURPOSE: The purpose of this study was to report the diagnosis and management of entrapment neuropathy of the lateral antebrachial cutaneous nerve (LABCN) presenting as lateral elbow pain. METHODS: Twenty-three patients with lateral elbow pain were diagnosed with entrapment of the LABCN. Six patients also had paresthesia of the distal forearm. Diagnosis was made by clinical evaluation and confirmed with diagnostic injection of 1% lidocaine. Electrodiagnostic evaluation was positive in all patients. All patients were treated conservatively. Seven patients improved and 16 patients had surgical decompression of the LABCN at the elbow and distal arm with partial resection of the lateral margin of the biceps tendon. Postoperative follow-up evaluation averaged 45 months. RESULTS: Fourteen patients had complete relief of pain and 2 patients continued to have minimal to mild pain. Of the 6 patients who had preoperative paresthesia only 1 patient had persistent mild paresthesia of the radial side of the distal forearm. Range of motion and grip and pinch strength returned to normal values. All patients returned to their preoperative daily and work activities. CONCLUSIONS: Entrapment neuropathy of the LABCN should be considered in the differential diagnosis of elbow pain. Electrodiagnostic evaluation can be very useful in establishing and confirming the diagnosis. Surgical treatment of patients who do not respond to conservative treatment is simple yet effective in improving the patients' symptoms. Patients who present with paresthesia usually require surgical intervention because paresthesia represents a more progressive stage of the nerve entrapment.
PURPOSE: The purpose of this study was to report the diagnosis and management of entrapment neuropathy of the lateral antebrachial cutaneous nerve (LABCN) presenting as lateral elbow pain. METHODS: Twenty-three patients with lateral elbow pain were diagnosed with entrapment of the LABCN. Six patients also had paresthesia of the distal forearm. Diagnosis was made by clinical evaluation and confirmed with diagnostic injection of 1% lidocaine. Electrodiagnostic evaluation was positive in all patients. All patients were treated conservatively. Seven patients improved and 16 patients had surgical decompression of the LABCN at the elbow and distal arm with partial resection of the lateral margin of the biceps tendon. Postoperative follow-up evaluation averaged 45 months. RESULTS: Fourteen patients had complete relief of pain and 2 patients continued to have minimal to mild pain. Of the 6 patients who had preoperative paresthesia only 1 patient had persistent mild paresthesia of the radial side of the distal forearm. Range of motion and grip and pinch strength returned to normal values. All patients returned to their preoperative daily and work activities. CONCLUSIONS:Entrapment neuropathy of the LABCN should be considered in the differential diagnosis of elbow pain. Electrodiagnostic evaluation can be very useful in establishing and confirming the diagnosis. Surgical treatment of patients who do not respond to conservative treatment is simple yet effective in improving the patients' symptoms. Patients who present with paresthesia usually require surgical intervention because paresthesia represents a more progressive stage of the nerve entrapment.