Long term results of radial tunnel release--the effect of co-existing tennis elbow, multiple compression syndromes and workers' compensation.

SUMMARY: Surgical decompression of radial tunnel syndrome (RTS) remains controversial because the results are unpredictable. This study is a retrospective analysis of the long term outcomes of RTS release and a comparison of our findings with previous studies. Thirty-three extremities in 31 patients underwent decompression for radial tunnel syndrome between 1994 and 2003, of which 27 extremities in 25 patients were available for long term follow up after an average of 57 months (range 16 to 106 months). Outcomes were evaluated using the criteria of Ritts et al. (1987). For 16 patients (18 of 27 extremities), the outcome was rated as good (67%), for four patients (four extremities) as fair (15%), and for five patients (five extremities) as poor (18%). The outcome was better in patients with simple RTS (86% good results) compared with patients with additional nerve compression syndromes (57% good results), or patients with coexisting lateral epicondylitis (70% vs 43% good results), or patients who were receiving workers' compensation (73% vs 58% good results). One-third of patients still had moderate or severe disability which affected their ability to work, but 82% had relief of their pain. Surgical decompression is therefore beneficial for simple RTS, but may be less successful if there are co-existing additional nerve compression syndromes or lateral epicondylitis or if the patient is receiving workers'compensation.