The trochlear groove is the central depression in the trochlea of the humerus that guides the olecranon process of the ulna during elbow flexion and extension, functioning as a hinge joint track. This groove maintains the elbow's hinging axis and prevents lateral translation.
The trochlear groove geometry determines elbow alignment and carrying angle. Trochlear hypoplasia or flattening predisposes to ulnar instability and medial elbow impingement. In elbow arthroplasty, the trochlear component must restore the normal groove geometry to prevent bearing wear and instability. Osteochondral lesions of the trochlear groove produce medial elbow pain with terminal elbow extension.
Osteochondral lesion of the trochlear groove from repetitive valgus loading producing medial elbow pain at terminal extension, requiring arthroscopic debridement or osteochondral grafting depending on lesion size.
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