3,4,6,7 … As well as the differential width of the cortex in the femoral neck, the inferomedial side is strengthened by the calcar femorale, a vertical plate of bone lying deep to the lesser trochanter, that is formed as a result of traction of the iliopsoas which separates the femoral cortex into two distinct layers, the calcar femorale and the medial femoral cortex (Thompson, 1907; Dixon, 1910; Tobin, 1955; Harty, 1957; Garden, 1961; Wroblewski et al., 2000). 12-2) – proximal, middle and distal. Left: proximal end; right: distal end. The origin of the iliofemoral ligament is the same as that of the capsular attachment inferior to the anterior inferior iliac spine, and that capsular attachment is highly adaptive to mechanical stress, on the basis of its osseous impression, attachment width and histological features (Tsutsumi et al. Iliofemoral ligament– This is The rim of the acetabulum is lined with a fibrocartilagenous acetabular labrum, part of which bridges across the acetabular notch as the transverse acetabular ligament. The acetabulum has a ‘C’-shaped articular surface (Fig. Its proximal attachment is between the anterior inferior iliac spine and the acetabular rim. As does the front split where the rear leg is hyper-extended at the hip. Poirier’s facet is an extension of the articular surface of the head onto the anterior upper surface of the neck and is sometimes accompanied by a ridge of the upper surface of the neck known as the cervical eminence (Meyer, 1924a; Odgers, 1931; Schofield, 1959; Kostick, 1963). This pit is for insertion of the tendon of obturator externus, a muscle that originates around and across the membrane that stretches across the obturator foramen of the os coxae. De iliofemorale ligament een ligament van het heupgewricht dat zich vanaf het darmbeen de femur vóór het gewricht. However, Indians from South America have relatively straight femora (Gilbert, 1976). Right femur, proximal. The trochanteric fossa is the pit excavated into the posteromedial wall of the greater trochanter. 12-2). By continuing you agree to the use of cookies. Range of motion exercises (wall slides, etc.) The auricular surface and related structures are posterior and medial. Kate (1976) distinguished between torsion inherent in the neck and that due to torsion in the shaft itself. The inferior gluteal line is a horizontal line just superior to the acetabulum. Due to the angle between the neck and the shaft this axis of rotation does not pass though the shaft of the femur. The obturator vessels and nerve pass through this groove. The shaft can be roughly divided into three parts (Fig. See orthopedic texts for arthrodesis techniques. When correctly oriented, the anterior superior iliac spine should be in the same paracoronal plane as the most anterior point on the pubis. The lateral surface of this notch is elevated, projecting more anteriorly than the medial boundary of the notch. The lunate surface is the crescent-shaped articular surface within the acetabulum where the femoral head actually articulates. It is intimately connected with the joint capsule, and serves to strengthen the joint by resisting hyperextension. This arrangement in humans, in contrast to the great apes, which have a cortex of more uniform thickness, is similar to that found in some fossil hominids, which are therefore thought to have been bipedal. Methods: In a novel cadaveric model, stents were bilaterally inserted into the veins in the iliofemoral region. The joint is laterally related to the iliotibial tract and medially to the structures in the pelvic cavity. This generous supply of the lower end of the femur contrasts with that of the upper end and explains the relative lack of ischaemic necrosis after fractures of the distal end. Ferris et al. The obturator internus muscle, a lateral rotator and sometimes abductor of the femur at the hip, passes through this notch. However, Wanner (1977) suggested that other factors were responsible as there was considerable variation in the individual components that comprise the groove and no direct correlation between its lateral lip and the bicondylar angle (see ‘the patella’). The pubis has one center at the symphysis (the “ventral rampart”), and the ischium has one at the tuberosity that extends along the inferior pubic ramus. The capsule of the hip joint extends to the intertrochanteric line anteriorly but only reaches about halfway down the neck posteriorly and this alignment has important consequences for the blood supply of the femoral head and neck. The femoral head is pressed upward by ground forces matching the weight of the body applied by the overhanging ‘roof’ of the acetabulum (Kapandji 1987). An appreciation of the clinical anatomy of the calcar femorale is important in the understanding of the biomechanics following total hip replacement. Prasad et al. The piriformis, the obturator internus tendon, the two gemelli and the sciatic nerve are the immediate posterior relations (Fig. Medial rota-tion tightens the ischiofemoral ligament. Flexion is achieved by the psoas major and the iliacus assisted by the sartorius, the rectus femoris and the pectineus. There are a variety of minor anomalies at the lower end of the femur, some of which appear to be of such common occurrence that they could be regarded as normal. For isolated acetabula, the acetabular notch is inferior and faces slightly anteriorly. S. Jacob MBBS MS (Anatomy), in Human Anatomy, 2008. Its medial surface bulges away from the axis of the shaft. Formicola et al. The head of the femur is mostly covered by articular cartilage (hyaline). The posterior aspect of the neck often bears a groove produced by this tendon as it approaches the fossa. Iliofemoral ligament – This is a Y-shaped ligament that connects the pelvis to the femoral head at the front of the joint. The lateral side of the condyle forms the medial wall of the intercondylar fossa and provides an attachment for the posterior cruciate ligament. The synovial membrane lines the capsule and all intracapsular structures except the articular cartilage in the acetabulum and on the femoral head. These ligaments strengthen the knee joint. Postural factors such as squatting had been suggested to account for these marks, but there now appears to be general agreement that this is an unlikely explanation as they occur with equal frequency in both habitual and non-habitual squatters (Kate, 1963; Kostick, 1963; Trinkaus, 1975). This muscle acts to rotate the thigh laterally at the hip. Sato K(1), Uchiyama E, Katayose M, Fujimiya M. Author information: (1)Department of Anatomy, School of Medicine, Sapporo Medical University, South 1jo West 17chome, Chuo-ku, Sapporo, 060-8556, Japan, satokao@kinjo.ac.jp. The medial condyle is the large, articular knob on the medial side of the distal femur. The ligament limits extension of the hip joint. The distal half of the posterior aspect of the neck is therefore extracapsular. Finnegan (1978) viewed the rare occurrence of an exostosis in the fossa as a non-metric epigenetic trait. The movement is limited by the tension of the hamstrings. The trochanter is a large, roughened protuberance of bone to which are attached the gluteus medius, gluteus minimus, piriformis and obturator internus muscles. Primary repair of the ligaments have the same difficulty as described in the elbow and carpal joints. The anterior gluteal line is a line that curves posteroinferiorly through the fossa posterior to the iliac pillar. The iliofemoral ligament connects the pelvis to the femur and supports the hip joint during hip extension. The fibrous capsule is reinforced by three strong extracapsular ligaments. Right os coxae, lateral. It anchors the sartorius muscle and the inguinal ligament. The distribution of cortical bone in the proximal femur is believed to be a critical component in determining fracture resistance. Figure 12.3. The lateral condyle is the large, protruding, articular knob on the lateral side of the distal femur. It is often, but not always, accompanied by a so-called sub (hypo) trochanteric fossa (crural trough; Appleton, 1922; Schofield, 1959; Finnegan, 1978), which is a longitudinal hollow between the gluteal tuberosity and the lateral margin of the shaft. The obturator externus (Fig. The acetabulum is the laterally facing, hemispherical hollow that forms the socket of the hip, which articulates with the head of the femur. Abduction tightens the pubofemoral and the ischiofemoral ligaments. External coaptation during surgical healing was provided by using a Robert-Jones bandage, replaced by a fiberglass cast after 3 weeks. This foramen exits the bone distally. Although the tendon and deep aponeurosis of the gluteus minimus and iliopsoas are partly connected to the same region of the capsule, the precise location … Robust development of the lips of the linea aspera must be distinguished from the condition of pilastry, where a strong bar of bone runs down the posterior surface of the shaft (Hepburn, 1896; Hrdlička, 1934a). It helps in limiting over-extension of the hip. The middle third of the shaft is occupied posteriorly by the linea aspera, which is a roughened area for muscular attachment. Bridgeman and Brookes (1996) and Brookes and Revell (1998) found that the number and distribution of arteries to the femoral diaphysis varied both with sex and side but admitted that it is difficult to relate this bilateral asymmetry to functional differences. However, some of the studies have been carried out on undocumented material, where sex was determined from morphological or archaeological evidence and they therefore inevitably involve circular reasoning (see Chapter 2). ral ligament and also the pubofemoral ligament. Cortical thickness can now be assessed using computed tomography (CT) whereby thickness estimates can be displayed as a colour map on the surface of the bone under investigation (Treece et al., 2010). The iliac fossa is the smooth hollow on the medial surface of the iliac blade. The deeper part of the acetabulum is non-articular and is occupied by the Haversian pad of fat. of hip movements. It collects the spiral line, pectineal line, and gluteal tuberosity proximally and divides into the medial and lateral supracondyloid ridges distally. There are several anomalies described around the head and neck of the femur. Posteriorly, the trochanters are joined by the rough intertrochanteric crest, bearing a raised tubercle in the centre for the attachment of the quadratus femoris muscle, which is a lateral rotator of the hip. It is an attachment for part of the gluteus maximus muscle, an extensor, lateral rotator, and abductor of the femur at the hip. Parsons (1914), Stopford (1914), Nadgir (1917) and Frazer (1948) described supracondyloid tubercles on the popliteal surface superior to the condyles and just lateral to the epicondylar lines. (1996a) reported the adult range to be 110–140 degrees and Isaac et al. The blood vessels supplying the femoral head lie deep to these. It is an attachment point for the lateral collateral ligament of the knee. The normal osteoporotic changes that occur with age accentuate the spiral pattern by increasing the contrast between more and less dense bone. 167); • pubofemoral—arising from the iliopubic junction to blend with the medial aspect of the capsule; • ischiofemoral—arising from the ischium to be inserted into the base of the greater trochanter. (1990) and Feldesman and Fountain (1996) have discussed the problem of estimation of height, both in fossil genera and in skeletal remains of unknown ‘ancestral’ origin. Early injection studies of the blood supply to the head (Trueta and Harrison, 1953; Trueta, 1957) have been revised and re-interpreted by Crock (1965, 1967, 1996)Crock (1965)Crock (1967)Crock (1996). Natural size. Indeed, Bolanowski et al. The posterior superior iliac spine is the posterior terminus of the iliac crest. On its lateral surface (Fig. This article incorporates text in the public domain from page 335 of the 20th edition of Gray's Anatomy (1918), Right hip-joint from the front. It anchors the extensor muscles of the thigh at the hip, including the semitendinosus, semimembranosus, biceps femoris (long head), and quadratus femoris. This muscle adducts the thigh at the hip. This helps prevent lateral dislocation of the patella during full extension of the knee. They vary from prominent to imperceptible between individuals and across their paths. 6.7). Methods of determination of sex from fragmentary remains can be found in Black (1978b), MacLaughlin and Bruce (1985), Seidemann et al. Stability is achieved by a number of factors including its thick capsule and strong ligaments. Directly superior to this is the prominent adductor tubercle to which the hamstring portion of the adductor magnus muscle is attached, while between it and the epicondyle, the medial head of the gastrocnemius muscle takes its origin. The iliac tuberosity is the roughened surface just posterosuperior to the auricular surface. The iliofemoral ligament essentially ties the femur bone into the pelvis and is considered to be the strongest ligament in the whole body. The iliofemoral ligament is the strongest ligament in the body and attaches the anterior inferior iliac spine (AIIS) to the intertrochanteric crest of the femur. It must be noted that this curvature should not be used to predict ancestry in forensic cases. 6.53). * Reference 11. It supports all of the body's weight during standing, walking, and running. Iliofemoral ligament The iliofemoral ligament is a thick triangular ligament that lies on the anterior and superior aspects of the hip joint, and blends with the joint capsule. There are three primary and five secondary centers of ossification in each os coxae. The mobility is due to the long femoral neck which joins the shaft at an angle. (1993), also using ultrasound on dry bone, have used four different methods of measuring anteversion, which they have compared to previous osteometric studies. The hip joint's design provides for excellent stability, unlike that of the shoulder, which is designed more... Lower limb. o Iliofemoral ligament What does it extend to and from What movement does it from KIN 2500 at Louisiana State University Front oversplits require even more mobility to attain proper hip hyperextension. Many of the early reports are tabulations of measurements, indices and anomalies. Right femur, lateral. The iliofemoral ligament (also called the Y ligament) extends diagonally across the front of the hip joint and it is the strongest ligament in the body. It is the insertion of the pectineus muscle, which originates from the pubic part of the os coxae and acts to adduct, laterally rotate, and flex the thigh at the hip. However, according to our data, the inguinal ligament itself is not a point of compression at all; the distance between the inguinal ligament and vein is … The blood supply of the lower end of the femur is via radiate arteries, which penetrate the condyles from the circumference. Craig (1995) found that there is a consistent and statistically significant difference between American Blacks and Whites in the intercondylar shelf angle (between the roof of the intercondylar fossa and the posterior surface of the shaft). Right adult femur: (A) lateral condyle; (B) inferior. Fragmentary iliac blades might be mistaken for cranial or scapular fragments. The changing radiographic patterns made by the trabeculae at different periods of life have been used, both by clinicians to investigate osteoporosis (Hall, 1961; Singh et al., 1970) and by anthropologists as a means of establishing age at death (Acsádi and Nemeskéri, 1970; Lovejoy et al., 1985a; Walker and Lovejoy, 1985). 6.22). When a single artery enters in the middle segment of the medullary cavity, it immediately bifurcates to supply the upper and lower regions of the shaft (Crock, 1967, 1996). Measurements can vary from −25 to +42 degrees, but very large variations are probably due to difficulties of measurement and differences in methodology (Stirland, 1994), although smaller differences may be found between populations. The intercondylar fossa, or notch, is the nonarticular, excavated surface between the distal and posterior articular surfaces of the condyles. Right os coxae, medial. Our purpose was to analyze the anatomy and quantitative contributions of the hip capsular ligaments. Unlike many bones that gain their names because of perceived similarities to common objects, the os coxae resembles no common object and thus has earned the informal name innominate—the “bone with no name.” The os coxae differs in males and females, with its anatomy representing a compromise between the demands of locomotion and birthing. ), https://en.wikipedia.org/w/index.php?title=Iliofemoral_ligament&oldid=969844074, Wikipedia articles incorporating text from the 20th edition of Gray's Anatomy (1918), Creative Commons Attribution-ShareAlike License, This page was last edited on 27 July 2020, at 18:35. The presence of a third trochanter is often accompanied by a flattening, or platymeria, of the upper part of the shaft. (1996a) calculated regression equations for reconstruction of femoral length from markers at the proximal end. [3], As the hip flexes, the tension in the ligament is reduced and the amount of possible rotations in the hip joint is increased, which permits the pelvis to tilt backwards into its sitting angle. With a force strength exceeding 350 kg (772 lbs),[1] the iliofemoral ligament is not only stronger than the two other ligaments of the hip joint, the ischiofemoral and the pubofemoral, but also the strongest ligament in the human body and as such is an important constraint to the hip joint. The eighth center (“os cotyledon”) is located in the depth of the acetabulum. The lateral lip of the linea aspera marks the lateral border of the linea aspera and serves as the site of insertion of vastus lateralis, and the short head of biceps femoris. 6.54). Tim D. White, ... Pieter A. Folkens, in Human Osteology (Third Edition), 2012. The ligament of the head of femur which extends from the transverse acetabular ligament and the fovea on the head of femur is intracapsular (Fig. – L4 and L5 modulate extension, abduction, and lateral rotation. The cortical bone on the inferior surface of the neck is about twice as thick as that superiorly (Lovejoy, 1988). In a standing posture, when the pelvis is tilted posteriorly, the ligament is twisted and tense, which prevents the trunk from falling backwards and the posture is maintained without the need for muscular activity. 12-3A) it bears the protruding lateral epicondyle for the fibular (lateral) collateral ligament of the knee joint. The linea aspera is the long, wide, roughened, and elevated ridge that runs along the posterior shaft surface. The literature on the calcar has been reviewed by Newell (1997), who revealed that its function appeared to be interpreted differently by anatomists and orthopaedic surgeons. The surface of the ischial tuberosity faces posterolaterally. The cranial bones are, however, of more uniform thickness. Figure 12.5. Often AP radiographs of the adult femur, and less commonly, adolescents, show two parallel lines enclosing an area of increased radiodensity in the middle of the shaft. It is also referred to as the Y-ligament (see below). It is a point of attachment for the medial collateral ligament of the knee. A surgical technique has been described in a rabbit in which transosseous tunnels are created where the medial long collateral ligament originates (medial malleolus) and inserts (talus).55 A nylon suture is passed through the tunnels in a figure-of-eight pattern to replace the function of the damaged ligament. The movement is limited by the tension of the hamstrings. Meyer (1924b) described supracondylar fossae on the anterior surface of the femur, which were ascribed to pressure exerted by the osteophytic edges of patellae deformed by arthritis. The iliofemoral ligament helps to link the femur bone to the hip. The external fixator is placed with the limb in a normal standing position for 2 to 6 weeks.24 Small K-wires can be used for arthrodesis in conjunction with splints. It was proposed that the stresses that occur due to weight-bearing are compensated for superiorly by the abductors of the hip, which run parallel with the neck, but that inferiorly the cortex has to be thickened. For the bones to hold us up they generally stack one on top of the other transferring weight up and down through the skeleton. A pit (fovea capitis), situated below the centre of the head and containing nutrient foramina, provides attachment for the ligament of the head. In some modern populations, there appears to have been a change in recent times in femoral shaft/neck geometry and this is thought to be a factor in the recent significant increase in femoral neck fractures. The meric index (AP (anteroposterior) diameter × 100/mediolateral diameter), taken at the level of the spiral line, can vary from 56 to 128 with 75 or less being considered platymeric (Hepburn, 1896; Parsons, 1914; Holtby, 1918; Schofield, 1959). Pubofemoral ligament – This is a triangular shaped ligament that extends between the upper portion of the pubis and the iliofemoral ligament. However, a survey of neck-shaft angles across a representative sample of recent and modern population samples recorded a wide degree of variability (Anderson and Trinkaus, 1998). (1985) found that the incidence of a third trochanter was correlated positively with short femora, which had robust proximal diaphyses. The medial side of the condyle forms the lateral wall of the intercondylar fossa and bears a smooth surface for the anterior cruciate ligament. The posterior gluteal line is more vertically placed, near the posterior edge of the ilium. 6.52). The pectineus and adductor brevis muscles are attached between the spiral line and the tuberosity. The ischial ramus is posterior, and the superior pubic ramus is anterior. ), Structures surrounding right hip-joint. Coxofemoral luxations are also rare and can sometimes be reduced in a closed fashion under deep sedation or general anesthesia. It is S-shaped when viewed superiorly. The incidence of anomalies at the lower end of the femur appears to be higher in populations whose postural habits involve long periods with flexed knees, either seated on very low stools, or squatting with buttocks on heels, knees apart and toes turned outwards (Charles, 1893;3 Siddiqi, 1934; Kostick, 1963). It constitutes more of a sphere than the hemispherical humeral head. Extension, the reverse of flexion, is possible to a range of about 20° produced by gluteus maximus at the extremes of movements and hamstrings in the intermediate ranges. The descending part below, is weaker and runs parallel to the femoral shaft. Anteriorly, passing across the base of the neck is the roughened intertrochanteric line, to which are attached the two distal ends of the Y-shaped iliofemoral ligament. Figure 12.8. Many of the abdominal muscles originate on the crest. 2019b). Right femur, medial. The medial lip is shallower but extends further posteromedially towards the intertrochlear notch to provide extra-articular surface for the most medial facet on the patella when the knee is fully flexed. Gluteal lines are rough, irregular lines that demarcate the attachment of the gluteal muscles on the lateral surface of the ilium. The arcuate line is an elevation that sweeps anteroinferiorly across the medial surface of the os coxae from the apex of the auricular surface toward the pubis. Iliofemoral Ligament The hip. If the knee is bent to remove hamstring influence, the thigh can normally be flexed to 135° at the hip. The medial condyle extends more distally than the lateral condyle. The obturator externus groove is a shallow depression aligned laterally and superiorly across the posterior surface of the femoral neck. This shape is considered to be the main factor preventing the patella from dislocating laterally which, especially in females, has a high bicondylar angle. Introduction. These muscles are crucial in stabilizing the trunk when one leg is lifted from the ground during bipedal locomotion. They arise from the descending medial and lateral genicular arteries, which are branches of the femoral and popliteal arteries (Crock, 1962, 1967, 1996).
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