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首页> 外文期刊>Journal of orthopaedics and traumatology: official journal of the Italian Society of Orthopaedics and Traumatology >Extacorporeal shock wave therapy unsuccessful for chronic medial epicondylitis
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Extacorporeal shock wave therapy unsuccessful for chronic medial epicondylitis

机译：体外冲击波疗法未成功治疗慢性内侧上con炎

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Medial epicondylitis is a chronic noninflammatory condition resulting from mechanical injury. Despite many treatment options, including rest, medications, physiotherapy and operative interventions, the results are too often poor; thus new treatment options are sought. We treated 4 men with chronic epicondylitis (5 affected joints) with extracorporeal shock wave therapy after failed attempts of other treatments. The patients’ complaints were graded with the Nirschl scoring system prior to and six months after therapy. The treatment consisted of three sessions, at 20-day intervals, of 3000 pulses of ultrasonic shock waves from a Piezolith 3000 unit (energy dosage was gradually increased to reach step 10 equaling 0.9 mJ/mm2). At the 6-month follow-up, no patient was pain free. Three cases had slightly lower Nirschl scores than prior to the procedure but the patients rated this difference as insignificant; two cases were unchanged. No complications were observed but all patients rated the procedure as very unpleasant. The well recognized biologic effects of ultrasonographic waves (heat generation, oscillations, cavitation, etc.) that result in functional and structural changes of cellular membranes with sonochemical reactions (acceleration of normal metabolism, oxygenation and reduction in water solutions, polymer degradation, etc.), even if present in our cases, did not result in a noticeable decrease of symptoms, even though we used high energy and more impulses per session. Significant variations in methodology make inconclusive the results of numerous reports on the use of extracorporeal shock waves in epicondylar degenerative problems, although ineffectiveness of such therapy is the conclusion of a review by Haake and colleagues.
机译：内侧上con炎是由机械损伤引起的慢性非炎性疾病。尽管有许多治疗选择，包括休息，药物治疗，物理治疗和手术干预，但结果往往很差;因此寻求新的治疗选择。在尝试其他治疗方法失败后，我们采用体外冲击波疗法治疗了4名患有慢性上con炎的男性（5个受累关节）。在治疗前和治疗后六个月用Nirschl评分系统对患者的主诉进行评分。该处理包括三个周期，每20天间隔一次，来自Piezolith 3000单元的3000个超声波冲击波（能量剂量逐渐增加，达到等于0.9 mJ / mm2的步骤10）。在6个月的随访中，没有患者没有疼痛。 3例患者的Nirschl评分比手术前略低，但患者将该差异评为微不足道。两个案例没有变化。没有观察到并发症，但是所有患者都认为该手术非常不愉快。超声波的良好生物学效应（热量产生，振荡，空化等）导致声波化学反应（促进正常新陈代谢，氧化和水溶液还原，聚合物降解等）导致细胞膜的功能和结构变化。 ），即使在我们的病例中也是如此，即使我们每次使用高能量和更多的冲动，也不会导致症状的明显减轻。方法学上的显着差异使得有关reports外退行性问题中使用体外冲击波的众多报道的结果尚无定论，尽管这种治疗方法无效是Haake及其同事的综述的结论。

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