ABSTRACT
La inestabilidad de codo es una enfermedad de diagnóstico difícil en determinados casos, y puede conllevar unos problemas limitantes para la funcionalidad diaria como los bloqueos articulares, los resaltes, la debilidad muscular y el dolor persistente. Presentamos el caso de un paciente con clínica de epicondilitis con antecedente previo de una caída sobre el brazo afecto. Tras efectuar los tratamientos convencionales no agresivos y no obtener mejoría, se realiza cirugía sobre la afectación tendinosa. El caso evoluciona hacia la persistencia del dolor, y a una clínica de inestabilidad articular que acaba por precisar cirugía reconstructiva ligamentaria sobre el complejo externo. En el control a los 6 meses de la última intervención ha desaparecido la clínica de inestabilidad, pero aún persisten las molestias en cara externa y un déficit a la extensión de 30°. Es importante tener en consideración ante un cuadro de epicondilitis con traumatismo previo, rebelde a los tratamientos conservadores, la posibilidad de que haya una inestabilidad de codo subyacente, descartándola con una correcta exploración física y con pruebas complementarias si se precisan (AU)
Elbow instability is a difficult to diagnose condition in certain cases, and could lead to some problems that limit daily functioning, such as joint blocks, bumps, projections, muscle weakness, and persistent pain. A case is presented of a patient with a clinical picture of epicondylitis, with a previous history of a fall on the affected arm. As there was no improvement after performing conventional non-aggressive treatment, surgery was performed on the affected tendon. The outcome of this was persistent pain and clinical instability of the elbow that ended up requiring surgery to reconstruct the ligament over the external complex. In follow-up 6 months after the operation, the clinical instability had disappeared, but there was still external discomfort and a 30° extension deficit. When faced with a picture of epicondylitis with a previous injury that does not respond to conventional therapies, it is important to take into account the possibility of an underlying elbow instability, ruling this out with a correct physical examination and, where necessary, with the appropriate complementary tests (AU)
Subject(s)
Humans , Male , Adult , Tennis Elbow/complications , Tennis Elbow/diagnosis , Muscle Weakness/complications , Muscle Weakness/diagnosis , Pain/complications , Elbow/pathology , Elbow , Elbow Joint/pathology , Elbow Joint , Radius/pathology , RadiusABSTRACT
Elbow instability is a difficult to diagnose condition in certain cases, and could lead to some problems that limit daily functioning, such as joint blocks, bumps, projections, muscle weakness, and persistent pain. A case is presented of a patient with a clinical picture of epicondylitis, with a previous history of a fall on the affected arm. As there was no improvement after performing conventional non-aggressive treatment, surgery was performed on the affected tendon. The outcome of this was persistent pain and clinical instability of the elbow that ended up requiring surgery to reconstruct the ligament over the external complex. In follow-up 6 months after the operation, the clinical instability had disappeared, but there was still external discomfort and a 30° extension deficit. When faced with a picture of epicondylitis with a previous injury that does not respond to conventional therapies, it is important to take into account the possibility of an underlying elbow instability, ruling this out with a correct physical examination and, where necessary, with the appropriate complementary tests.
