Totlis Trifon, Otountzidis Nikolaos, Papadopoulos Stavros, Piagkou Maria, Natsis Konstantinos
Department of Anatomy and Surgical Anatomy, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, P.O. Box 300, 54124, Thessaloniki, Greece.
Department of Anatomy, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
Surg Radiol Anat. 2019 Nov;41(11):1333-1336. doi: 10.1007/s00276-019-02310-y. Epub 2019 Aug 31.
The typical anatomical illustration of the trochlear notch articular surface includes a transverse rough non-articular ridge which separates the olecranon and coronoid part of the joint. This transverse ridge, the "bare area", is not covered by cartilage and represents the optimal entry point for olecranon osteotomies. Aim of the present study was to encounter the anatomical variations in the morphology of the trochlear notch articular surface.
Two-hundred seventy-three dried ulnae were inspected and a qualitative classification of the variations of the trochlear notch articular surface was done. Correlation to gender and side was examined.
Three distinct morphological patterns were observed. Separate olecranon and coronoid facets (Type I) were the most common pattern (165/273, 60.4%). Partial fusion of olecranon and coronoid facets (Type II) was observed in 75 out of 273 bones (27.5%), while a single olecranon and coronoid facet (Type III) was present in 33 out of 273 bones (12.1%). The occurrence of Type II and III was significantly more common in females (p < 0.001).
The most common morphological pattern of the proximal ulna articular surface was the olecranon and coronoid facets separated by the transverse ridge, which is considered as the typical anatomical pattern. The partial fusion of olecranon and coronoid facets was the second most common pattern (27.5%) and the single olecranon and coronoid facet with no transverse ridge present was the rarest one (12.1%). These variations affect the area covered by cartilage. They are noticeable in an elbow MRI and they may have implications on olecranon osteotomy. Absence of the transverse ridge may confuse the surgeon during elbow arthroscopy.
滑车切迹关节面的典型解剖图示包括一条横向的粗糙非关节嵴，该嵴将关节的鹰嘴部和冠突部分分开。这条横向嵴，即“裸区”，未被软骨覆盖，是鹰嘴截骨术的最佳切入点。本研究的目的是了解滑车切迹关节面形态的解剖变异情况。
检查了273根干燥尺骨，并对滑车切迹关节面的变异进行了定性分类。研究了其与性别和侧别的相关性。
观察到三种不同的形态模式。单独的鹰嘴和冠突小面（I型）是最常见的模式（165/273，60.4%）。273根骨头中有75根观察到鹰嘴和冠突小面部分融合（II型）（27.5%），而273根骨头中有33根存在单一的鹰嘴和冠突小面（III型）（12.1%）。II型和III型在女性中更为常见（p < 0.001）。
尺骨近端关节面最常见的形态模式是由横向嵴分隔的鹰嘴和冠突小面，这被认为是典型的解剖模式。鹰嘴和冠突小面的部分融合是第二常见的模式（27.5%），而不存在横向嵴的单一鹰嘴和冠突小面是最罕见的（12.1%）。这些变异影响软骨覆盖的面积。它们在肘部MRI中很明显，可能对鹰嘴截骨术有影响。横向嵴的缺失可能会在肘关节镜检查时给外科医生造成困扰。
