The medial elbow compartment is the ulnohumeral articulation between the trochlear notch of the ulna and the trochlea of the humerus, bounded medially by the ulnar collateral ligament and medially by the medial joint capsule. It is the primary load-bearing compartment of the elbow during valgus stress and the articulation responsible for elbow flexion-extension arc.
The medial compartment is the site of UCL insufficiency in throwing athletes, posteromedial impingement, and ulnohumeral arthrosis in advanced elbow osteoarthritis. Valgus stress during throwing creates compressive forces on the lateral radiohumeral compartment and tensile forces on the medial UCL simultaneously. Medial elbow arthroscopy via the anteromedial portal directly visualises the medial compartment and the anterior band of the UCL. Osteophytes in the posteromedial olecranon tip impinge against the posterior trochlea in the valgus extended position (thrower's elbow).
Osteophyte formation at the posteromedial olecranon tip impinging on the posterior medial trochlea during valgus extension, producing medial elbow pain at terminal extension in baseball pitchers and javelin throwers.
Degenerative arthritis of the medial elbow compartment producing stiffness, loss of terminal flexion and extension, and medial joint pain, managed with arthroscopic debridement, capsulotomy, and loose body removal.
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