The trochlea is the spool-shaped medial articular surface of the distal humerus, articulating with the trochlear notch of the ulna at the humeroulnar joint. Its central groove tracks the ulna during flexion and extension, and its medial lip is the primary contact surface. The trochlea is entirely covered by articular cartilage.
The trochlea is avascularly supplied in its central portion, making articular damage from distal humeral fractures difficult to heal without surgery. Trochlear fractures are rare in isolation but occur in capitellar-trochlear shear injuries (Dubberley Type II-III). The medial trochlear lip is a stabilising buttress against ulnar valgus instability. Avascular necrosis of the trochlea (Hegemann's disease) is a rare osteochondrosis in children.
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