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Ulnar trochlear notch articular surface has three morphological patterns: a neglected major anatomical feature.

Trifon Totlis1, Nikolaos Otountzidis2, Stavros Papadopoulos2

  • 1Department of Anatomy and Surgical Anatomy, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, P.O. Box 300, 54124, Thessaloniki, Greece. totlis@med.auth.gr.

Surgical and Radiologic Anatomy : SRA
|September 2, 2019
PubMed
Summary

The typical elbow joint has a ridge separating its parts, but variations exist. These anatomical differences in the trochlear notch, particularly the absence of this ridge, are more common in females and impact surgical procedures.

Keywords:
Anatomical variationsBare areaElbow anatomyElbow arthroscopyProximal ulnaSigmoid notch

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Area of Science:

  • Orthopedic Surgery
  • Human Anatomy
  • Radiology

Background:

  • The trochlear notch of the ulna is crucial for elbow joint articulation.
  • A transverse ridge typically separates the olecranon and coronoid facets of the trochlear notch.
  • This ridge, known as the 'bare area,' is a key landmark for olecranon osteotomies.

Purpose of the Study:

  • To investigate anatomical variations in the morphology of the trochlear notch articular surface.
  • To classify different patterns of facet articulation in the proximal ulna.
  • To determine the prevalence of these variations and their correlation with gender.

Main Methods:

  • Examination of 273 dried ulnae.
  • Qualitative classification of trochlear notch articular surface variations.
  • Statistical analysis of variations based on gender and side.

Main Results:

  • Three distinct morphological patterns were identified.
  • Type I (separate facets) was most common (60.4%).
  • Type II (partial fusion) occurred in 27.5% and Type III (single facet) in 12.1%.
  • Types II and III were significantly more prevalent in females (p < 0.001).

Conclusions:

  • The typical anatomical pattern features separate olecranon and coronoid facets.
  • Variations, including partial or complete fusion, are common and more frequent in females.
  • These variations influence the articular surface, are visible on MRI, and have implications for olecranon osteotomy and elbow arthroscopy.