DATE OF OPERATION: MM/DD/YYYY
PREOPERATIVE DIAGNOSIS: Right chronic lateral epicondylitis.
POSTOPERATIVE DIAGNOSIS: Right chronic lateral epicondylitis.
OPERATION PERFORMED:
1. Right elbow Nirschl procedure.
2. Partial ostectomy.
3. Partial common extensor release and repair.
SURGEON: John Doe, MD
ASSISTANT: Jane Doe, PA-C
ANESTHESIA: General.
COMPLICATIONS: None.
DRAINS: None.
IMPLANTS: None.
TOURNIQUET: Pneumatic tourniquet inflated to 200 mmHg on the right proximal arm.
OPERATIVE FINDINGS: Nirschl lesion with mucinoid degeneration in the common extensor origin.
INDICATIONS FOR OPERATION: The patient is a (XX)-year-old. The patient failed conservative care and came in now for elective lateral epicondyle Nirschl procedure. All the risks were explained preoperatively to the patient in detail, and informed consent was obtained from the patient.
DESCRIPTION OF OPERATION: The patient was transferred to the operating suite in good, stable condition. The patient was then placed supine on the operating table and underwent uncomplicated general anesthetic. His right upper extremity was prepped and draped thoroughly in the usual sterile fashion utilizing Betadine. Following exsanguination with an Esmarch bandage, pneumatic tourniquet was inflated to 200 mmHg on the right proximal arm.
A 2 to 3 cm incision over the lateral epicondyle was performed sharply. Hemostasis was obtained with electrocautery. Meticulous dissection revealed the common extensor origin, which was opened in line with the incision. The Nirschl lesion was identified and was ellipsed out sharply and partially the extensor origin was released.
Partial ostectomy was performed. Drill holes were placed in the lateral epicondyle. Copious irrigation was performed, and interrupted #1 Vicryl suture was used to approximate and repair the common extensor origin. Buried interrupted 3-0 Vicryl sutures were used to approximate the subcutaneous and dermis. The skin was augmented with Steri-Strips, Adaptic, 4 x 4s. Ace bandage and long arm splint and immobilizer were placed. The patient tolerated the procedure well and left the operating room breathing spontaneously with good neurovascular exam of the right upper extremity.
