The intervention on a dislocated elbow is often very complicated: it is difficult to correctly identify the problem, and fundamental to operate early because the joint stiffens very quickly; it is necessary to know its complex biomechanics to make the right surgical choice. Furthermore, after the shoulder, the elbow is the human body joint which most often suffers a dislocation.
In order to summarize the technological innovations and the techniques currently utilized in the treatment of dislocation and elbow instability, on Tuesday June 4th, at the Rizzoli Orthopaedic Institute, the Italian experts of elbow surgery meet Prof. Shawn O’Driscoll from the Mayo Clinic, the United States referral center for international orthopedics, within a day-event of live surgery and scientific in-depth analysis organized by dr. Roberto Rotini, Director of the Rizzoli’s Shoulder and elbow Surgery Structure.
“Road accidents, especially falls from motorbikes or bikes, sport traumas, but also simple falls to the ground can cause a dislocation of the elbow, often associated with fractures”, explains Rotini, who chairs the event together with O’ Driscoll. “In addition to this typology of traumatic origin, there is also a type of elbow instability which is connected to the repetitiveness of gestures at work, for instance in case of manual works implying the lifting of loads or the use of a pneumatic drill, or in the sports field and especially in throwing sports, like tennis or baseball”.
In case of traumatic events the long bones (humerus, ulna, radius), between which the elbow is located, discharge on the joint a high quantity of energy, causing the loss of “joint connections” with the breakage of all the ligaments. Once reduced, the dislocation can relapse and create the conditions for a recurring instability. On the other hand, repeated stress due to repetitive gestures creates a progressive “loosening” of the ligaments. In both cases, there are several methods to face the problem: from the ligaments’ reconstruction to the reparation of the fractures with screws and plates, from prostheses of the head of radius to external fixers.
“The in-depth knowledge of the different damages mechanisms is decisive to properly contextualize the patient and to choose the most appropriate treatment, in order to avoid recurring instabilities and dangerous joint stiffness – Rotini points out. – This is why the meeting with O’ Driscoll is especially significant: he is the number one in the world, his elbow biomechanical studies allowed him to compile the new classification of elbow dislocations and a protocol of treatment, adequate to the different medical cases, which are a benchmark at the international level”.
Dr. Rotini’s commitment to realize, at the Rizzoli Institute, a continuative, highly specialized path in elbow surgery started in 2007, and since then, periodic meetings with top international experts are being held. The Shoulder and elbow Surgery Complex Structure of the Rizzoli Orthopedic Institute, directed by Rotini, has treated in 2012 over 100 patients with elbow orthopedic problems.
The Mayo Clinic (Rochester, Minnesota, USA) is a periodical winner of the best orthopedic ward prize in the United States. It hosts an excellence school at the global level in elbow surgery, and implements the most important scientific studies in the sector. Its aim is declaredly didactic and no profit, and is translated into periodical high specialization courses held at the American site and regularly attended by Rotini and his collaborators.