Anconeus muscle flap transfer for failed surgical treatment of recalcitrant chronic lateral epicondylitis
Bibliographic record
Abstract
Abstract Background Chronic lateral epicondylitis can be a painful and functionally limiting condition of the elbow. Non-operative and standard surgical treatment results can vary. Moreover, outcomes for patients who have failed previous surgical treatment are limited. We report our experience using the anconeus muscle flap transfer in comparison to standard surgical treatment and report our clinical results. Methods We performed a retrospective case series of 19 patients with chronic lateral epicondylitis and failure of previous treatments that were managed with anconeus muscle flap transfer. There were 11 males and 8 females, with a mean age of 44 years (range 19-72); 13 were on the right side and 6 on the left. The average time from diagnosis to the surgical procedure was over 1 year (1-10 years) and the average follow-up period was 3.7 years (1-14 years). Results The average pain preoperatively was 6.61 and decreased postoperatively to 1.89 (range 0-10) (P < 0.0001). Complete flexion, extension and rotation of the elbow were present in all patients except one with a 5° extension lag. The average muscle strength was 4.5/5 and grip strength almost equivalent to the contralateral arm. No infection or other postoperative complications were observed. Patients were evaluated using the Roles and Maudsley score and demonstrated excellent results for 14 patients, good for 4, and poor for 1. The average time for return to work was 2.8 months (1-7 months). Ninety-five percent of patients were satisfied with the flap transfer and pain improvement. Conclusion The anconeus muscle flap transfer is a safe and acceptable procedure providing satisfactory results for chronic lateral epicondylitis of the elbow. This procedure can be useful for treating patients with continued pain after previous standard surgical release. Highlights
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".