CADAVERIC MAPPING OF AGNI-KARMA SITES IN TENNIS ELBOW

Abstract

Background: Tennis elbow is an overuse disorder affecting the common extensor tendon, especially extensor carpi radialis brevis at the lateral epicondyle. In Ayurveda, it may be correlated with Snayugata Vata, presenting with pain, stiffness, tenderness and restricted movement. Agni-Karma is indicated in disorders of Snayu, Sandhi and Asthi, but treatment points are usually selected by maximum tenderness without a standard anatomical map. Because the lateral elbow contains closely related tendons, ligaments, capsule and nerves, anatomical validation is necessary.

AIM To perform cadaveric mapping of proposed Agni-Karma sites for tennis elbow and define their relationship with the common extensor tendon, extensor carpi radialis brevis, lateral ligament complex, radiocapitellar joint, radial nerve and posterior interosseous nerve.

Primary Objective To determine the anatomical correspondence between proposed surface Agni-Karma points and the common extensor tendon origin.

Secondary Objectives To measure the dimensions of the common extensor tendon footprint. To identify the proximal, distal, anterior and posterior limits of the extensor carpi radialis brevis origin. To measure skin-to-tendon, skin-to-capsule and skin-to-bone depth at each mapped point. To develop a colour-coded procedure-safety map.

Materials and Methods: A descriptive cadaveric study will include at least 20 upper limbs. Surface landmarks was marked, a coordinate grid prepared and proposed treatment points placed over the common extensor origin. Layer-wise dissection will expose tendon footprints, ligaments and nerves. Distances and tissue depths was measured with a digital Vernier calliper in pronation, neutral and supination.

Anticipated Results: The safest region is expected near the common extensor origin, while anterior, distal and posteroinferior points may show greater risk.

Conclusion: Cadaveric mapping may improve the accuracy, reproducibility and safety of Agni-Karma in tennis elbow.