It acts as the site of origin and attachment of countless muscles and ligaments, and can be divided into three parts; proximal, shaft and also distal.
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In this article, we shall look at the anatomy of the femur – its attachments, bony landmarks, and clinical correlations.
The proximal facet of the femur articulates with the acetabulum that the pelvis to kind the hip joint.
It is composed of a head and also neck, and two bony procedures – the greater and lesser trochanters. Over there are additionally two bony ridges connecting the two trochanters; the intertrochanteric heat anteriorly and also the trochanteric comb posteriorly.Head – articulates through the acetabulum the the pelvis to type the i know well joint. It has actually a smooth surface, spanned with articular cartilage (except for a tiny depression – the fovea – where ligamentum teres attaches).Neck – connects the head that the femur through the shaft. That is cylindrical, projecting in a superior and medial direction. It is collection at an edge of about 135 levels to the shaft. This edge of projection enables for one increased selection of activity at the i know well joint.Greater trochanter – the many lateral palpable projection of bone that originates native the anterior aspect, just lateral come the neck.It is the website of attachment for many of the muscles in the gluteal region, such together gluteus medius, gluteus minimus and also piriformis. The vastus lateralis originates indigenous this site.An avulsion fracture of the greater trochanter can occur as a result of forceful contraction of the gluteus medius.Lesser trochanter – smaller 보다 the greater trochanter. It tasks from the posteromedial side of the femur, simply inferior to the neck-shaft junction.It is the website of attachment for iliopsoas (forceful contraction of i beg your pardon can reason an avulsion fracture that the lesser trochanter).Intertrochanteric line – a ridge the bone the runs in an inferomedial direction top top the anterior surface ar of the femur, spanning in between the two trochanters. After it overcome the lesser trochanter top top the posterior surface, it is known as the pectineal line.It is the website of attachment because that the iliofemoral ligament (the strongest ligament of the i know good joint).It also serves together the anterior attachments of the hip joint capsule.Intertrochanteric comb – like the intertrochanteric line, this is a ridge that bone the connects the two trochanters. It is located on the posterior surface ar of the femur. There is a rounded tubercle top top its superior fifty percent called the quadrate tubercle; where quadratus femoris attaches.
Fig 1 – The anterior surface ar of the proximal ideal femur.
Fig 2 – The posterior surface ar of the appropriate femur.
Clinical Relevance: Proximal Femur Fractures
Neck that femur fractures (NOFs) are significantly common and also tend come be continual by the elderly population as a an outcome of low energy falls in the visibility of osteoporotic bone. They are much more prevalent in women. In younger patient they often tend to happen as a an outcome of high energy accidents.
The distal fragment is frequently pulled upwards and also rotated laterally. This manifests clinically together a reduce and externally rotated lower limb.
These fractures deserve to be extensively classified into two main groups:Intracapsular – occurs in ~ the capsule of the hip joint. That can damage the medial femoral circumflex artery – and cause avascular necrosis the the femoral head.Extracapsular – the blood supply to the head of femur is intact, so avascular necrosis is a rare complication.
The obelisk of the femur descends in a slight medial direction. This brings the knee closer come the body centre of gravity, boosting stability. A cross section of the column in the center is circular however flattened posteriorly in ~ the proximal and distal aspects.
On the posterior surface of the femoral shaft, there are roughened ridges of bone, called the linea aspera (Latin for unstable line). This splits distally to kind the medial and lateral supracondylar lines. The flat popliteal surface lies between them.
Proximally, the medial border that the linea aspera becomes the pectineal line. The lateral border becomes the gluteal tuberosity, where the gluteus maximus attaches.
Distally, the linea aspera widens and forms the floor that the popliteal fossa, the medial and lateral borders kind the medial and lateral supracondylar lines. The medial supracondylar line end at the adductor tubercle, wherein the adductor magnus attaches.
Fig 3 – Posterior surface of the appropriate femoral shaft.
Clinical Relevance: Fractures of the Femoral Shaft
Fractures that the femoral shaft are frequently a high power injury however can happen in the elderly as a result of a low energy fall.
They can often occur as a spiral fracture, which causes leg shortening. The loss of leg size is early the bony pieces overriding, traction by their attached muscles.
As the an approach of injury is generally high energy, the surrounding soft organization may additionally be damaged. Neurovascular frameworks at risk incorporate the femoral nerve and artery. A closeup of the door femoral column fracture may result in considerable haemorrhage (1000-1500ml)
Fig 4 – Spiral fracture of the femoral shaft.
The distal end of the femur is qualified by the existence of the medial and lateral condyles, i beg your pardon articulate v the tibia and patella to type the knee joint.Medial and lateral condyles – rounded locations at the end of the femur. The posterior and also inferior surface articulate v the tibia and also menisci the the knee, if the anterior surface articulates with the patella. The more prominent lateral condyle helps prevent the natural lateral activity of the patella; a flatter condyle is an ext likely to an outcome in patellar dislocation.Medial and also lateral epicondyles – bony elevations ~ above the non-articular areas of the condyles. The medial epicondyle is the larger.The medial and lateral collateral ligaments of the knee originate from their respective epicondyles.
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Intercondylar fossa – a deep notch top top the posterior surface ar of the femur, between the two condyles. It has two facets for attachment of intracapsular knee ligaments; the anterior cruciate ligament (ACL) attaches to the medial element of the lateral condyle and also the posterior cruciate ligament (PCL) come the lateral element of the medial condyle.