教育研修講演

教育研修講演 11「肘とその疾患」

2月4日（土）8:40～9:40
第2会場（山形テルサ 1F テルサホール）

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The Elbow and its Disorders: my Experience and Perspective(also known as: The Elbow – the Joint we Love to Hate)
Bernard F. Morrey

Mayo Clinic, University of Texas Health Science Center, USA

The elbow has fascinated me throughout my career – and still does. Knowledge of the capricious
nature of the joint has earned it the well know designation of “predictable unpredictability “ This
characteristic extends both to its response to disease as well as to the uncertainty of many, if not
most treatments. For these reasons I consider the elbow as the “joint between（ shoulder and hand）
and beyond”（our understanding and effective treatment）. Some of these features are explainable dueto the unique anatomy from the skin to bone.
Skin. The elbow is a subcutaneous joint with little protection from skeletal muscle. Hence the tendency
for poor skin healing and increased infection.
Neurovascular. Three major nerves are intimate to the joint and are at risk both with trauma andsurgery. Vascular insult is associated with high risk of compartment syndrome.
Musculature, tendons. Trauma associated with highest risk of HO than any other joint.High incidenceof refractory, anterior, posterior, medial and lateral tendinopathy.
Capsule, ligaments. Exaggerated healing reaction of the capsule causes high grade contracture andarthrofibrosis often disproportionate to the injury that responds poorly to PT. Both collateral ligaments
are vulnerable to residual instability following injury.
Articulation. Arguably the most complex joint in the body. Trama to the articulation extremelycommon and extremely difficult to treat with traditional ORIF techniques. Prosthetic intervention for
acute trauma is not yet optimized. Primary osteoarthritis is the only joint where OA is treated withdebridement rather than replacement. Articular cartilage is preserved and the disease is manifest byosteophyte formation at the margin of the cartilage.
SUMMARY. The elbow anatomy is unique as is the response to insult. The legendary reputation ofpoor outcomes of intervention is changing, but there is a long way to go.
【Curriculum Vitae】
Bernard F. Morrey, M.D., is the emeritus chair of Orthopedics
and served on the Board of Governors of the Mayo Clinic. Heis Professor of Orthopedics at Mayo and at the University ofTexas, San Antonio. He is past President of the American
Academy of Orthopaedic Surgeons, of the American
Orthopaedic Association, and of the American Shoulder andElbow Surgeons and . is past chair of the Board of Trusteesof the JBJS Dr. Morrey is a Fulbright Scholar, He is amember of numerous specialty and international societies
including the Royal College of Surgeons, Edinbourgh andEFFORT. Dr. Morrey’s clinical interest is adult reconstructive
surgery, and he was the surgeon to Senior President andMrs Bush. Academic contributions include 25 years ofNIH supported research. He holds nine patents and has

authored 15 major textbooks under four different titles
and in six languages. He has over 450 peer-reviewed
publications. He has been named a distinguished alumnus
from St. Bernard College, the Mayo Clinic, the University ofTexas Medical Branch, Galveston.
.A NASA aerospace engineer , 1965-67, he received an MD
degree from the University of Texas Medical Branch in1971
and an MS in biomechanics from the U of Minnesota while
completing orthopaedic training at Mayo Clinic. After twoyears in the Air Force, he was awarded the Meritorious
Service Award, and joined the Mayo staff in 1978. His
wife, Carla, an RN, and he have four children, all in the
medical profession, and 12 grandchildren.

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2022年10月22日（土）～10月23日（日）