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Contemporary Management of Elbow and Forearm Disorders, An Issue of Hand Clinics

By Thomas Graham

The elbow and forearm are not the ‘‘forgotten joints’’, as some authors and lecturers like to report. Instead, this is the anatomic area of the upper extremity that seems to be equally shared by several groups of surgeons; however, the level of focus, interest, and sophistication of any one of these groups may not approach the levels found among those who focus on the hip, knee, shoulder, or wrist.

Every practitioner of general orthopedics has or will have experience with disorders of the forearm and elbow. The orthopedic traumatologist certainly can lay claim to acute problems that affect these frequently fractured bones. Our sports medicine colleagues have great experience in the pathologies associated with the throwing athlete.

Some adult reconstructive surgeons have migrated to perform total elbow replacement, drawing on their experience with lower extremity implant arthroplasty. Of course, the hand surgeon, with advanced interest in the anatomy and mechanics of the upper extremity, would be a logical choice for the mantle of the elbow surgeon.

If one or more groups are to be truly engaged in this area, it is incumbent on them to be facile with an entire spectrum of pathology and treatment. This includes the congenital and developmental differences, the fracture or dislocation, the range of elbow instability or stiffness, and the compromise of degenerative or inflammatory arthritis. Likewise, the forearm, as the intermediate joint between the wrist and the elbow, is sufficiently complex in mechanics and anatomy to demand specific attention and global understanding.

This is where an issue like this one hopefully comes in. The authors assembled have a breadth of knowledge and level of sophistication that matches their extraordinary ability to communicate. We have tried to cover some of the most important topics that all surgeons involved in the care of the elbow and forearm may encounter.

This issue is not written as a simple recapitulation of the historical context of elbow and forearm disorders, but as a useful insight into today’s thinking and tomorrow’s possibilities.

I thank these dedicated authors, the excellent editorial staff at W.B. Saunders, and my partners at the Curtis National Hand left for their many intellectual and professional contributions. I also thank my wife and daughters for their personal support and sacrifice.

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