Os supratrochleare anterius: a very rare clinical case report and review of literature

Abstract

Abstract Background: The accessory ossicles around the elbow are very rare variant structures, present in approximately 0.7% of cases. They can cause diagnostic problems and can be mistaken for pathological structures, especially when pain and limitation of elbow movements are present and a trauma can be traced in the patient’s history. They are of different nature, either presenting within muscle tendons as sesamoids (brachialis and triceps brachii muscles) or presenting intra-articularly probably as separated or accessory ossification centres. The least common is the os supratrochleare anterius. Case presentation: We present a case of a young male, presenting with chronic blocking and 20° limited flexion of his right elbow, which bothered him during his occupation as a locksmith. In history, he suffered minor trauma to the elbow 20 years ago. Detailed review of existing cases was performed. X-ray and CT showed a large ossicle in the coronoid fossa of the humerus and it was surgically extracted in small pieces. The patient left satisfied with no mention of complaints. There were found reports on 13 bones in 8 individuals (including ours) between 1949 and 1987 (and our in 2023). Conclusions: The os supratrochleare anterius is a very rare accessory ossicle of the elbow, located in the coronoid fossa of the humerus which can mimic many pathological states, and limit movements and causing pain around the elbow.