Anatomically, the head of the femur is held by the annular glenoid fossa. is considered the largest in the body, and therefore it has complex structure and executes a large number of motor functions. It is not easy for a person far from medicine to understand this, but to understand the causes and characteristics of the course of diseases of the femur, it is necessary.
Anatomy of the femur
Femur plays an important role in human body, since it is the largest tubular bone tissue in the skeleton. It, like other tubular bones, has two ends and a body. It is connected to the pelvis by the head, which ends in the upper proximal section.
The transition of the neck to the bone body ends with tubercles - trochanters. The bony body ends with the greater trochanter. There is a small depression on its medial surface. On the posterior side of the lower edge of the neck is the lesser trochanter. The greater one is connected to it by the intertrochanteric ridge, which runs along the back of the bone.
Functions of the hip
The entire lower limb is very important for a person, as it takes part in all movements of the body. In addition, the structure of the femur helps a person to be in an upright position, while bearing all static loads. Thanks to the femur, a person has the ability to walk, run, jump, play sports and perform more strenuous activities.
Major lesions of the femur
The main and most common injuries and lesions of the femur are: fracture greater trochanter femur, lesser trochanter fracture, bursitis, trochanteritis, tendinosis.
Types of trochanteric fractures
Trochanteric fractures are common in older people who have been diagnosed with a common disease such as osteoporosis. The most common trochanteric fractures are:
- Pertrochanteric simple and splintered. With such a fracture, the direction of the bone fracture line coincides with the one that connects the greater and lesser trochanters.
- Intertrochanteric. Such a fracture is characterized by the fact that the line of damage crosses the line that connects the greater and lesser trochanters.
Such injuries can be impacted or non-impacted, here is the clinical picture.
Thanks to muscle traction simple fractures the fragments are brought closer together. This facilitates bone healing and repositioning. Fractures with multiple fragments heal less well and require stronger fixation.
Intertrochanteric fractures are characterized by the fact that the work of the muscles around them does not contribute to healing in any way, but vice versa. This explains the importance of rigid fixation.
Greater trochanter fracture
This type lesions of the femur occur directly when force is applied directly to the area of the greater trochanter. In children, this is usually apophysiolysis with displacement of the diaphysis. In this case, 2 or 3 fragments of the greater trochanter may be completely crushed.
The most common lesions of the femur in older people are trochanteric and femoral neck fractures. With a fracture of the greater trochanter, the displacement of the bone can be directed upward, backward or forward. This is due to the fact that bone strength decreases over the years, and ordinary loads on the musculoskeletal system can become traumatic.
With a trochanteric fracture, the patient feels a sharp pain in the affected area, and upon palpation, slight mobility of the joint can be detected. In addition, a small crunching sound is characteristic of a fresh fracture. When a fracture occurs, the functional part of the hip is impaired, especially with regard to its abduction. If the greater trochanteric bone is fractured, you may be able to put weight on the affected leg, but you will feel a limp.
A patient with such a fracture can freely bend and straighten his leg in knee joint, however, attempts to turn the leg cause the patient severe pain. If he can lift his extended leg up, this means that there is no fracture of the femoral neck. It is worth noting that it is impossible to move the leg to the side if the femur is fractured due to the sharp pain in the affected area.
Greater trochanteric tendinosis
This disease is a fairly common pathology. Typical for people who overload the hip joint. This category mainly includes athletes.
With tendinosis in the greater trochanter, the inflammatory process begins in the ligaments and tendons, subsequently spreading to the tissue. The process begins at the point where the bone connects to the ligament. If a person does not pay attention to this, continuing to load the joint, the inflammation becomes chronic.
Provoking factors include the following:
- Joint injury.
- Failures in metabolic processes.
- Congenital dysplasia of the joints, which affects not only the articular surfaces, but the entire ligamentous apparatus.
- Irregularities at work endocrine system.
- Aging of the body, during which the structure of bones and ligaments changes.
- Systematic loads associated with monotony of work.
- Spread of infection into surrounding tissues.
- Inflammatory processes in the joints.
Clinical picture:
- Pain on palpation and movement of the limb.
- As you move, the bones begin to crunch.
- The skin at the site of the lesion changes color and becomes red.
- Local increase in temperature at the site of injury.
- The joint cannot perform its direct functions.
Inflammation
Bursitis of the trochanteric bursa is inflammation between the fascia lata and the greater trochanter. It is located on the outside of the femur in the upper part. At the same time, fluid collects in the bag, its walls expand, and pain appears. This disease is very dangerous due to its complications, including complete immobilization of the joint.
Pain that occurs at the protrusion of the femur of the greater trochanter is the most basic sign of the onset of pathology. While walking and with any impact on the joint, the pain intensifies. For more late stage the inflammatory process caused by bursitis begins to spread to the lower part of the thigh, thereby causing lameness in the patient. If even then the load on the affected limb does not decrease, then after a while painful sensations may also begin to appear at rest.
Diagnostics
To diagnose a fracture of the greater trochanter of the femur, an x-ray is taken; if necessary, the doctor decides to send the patient to computed tomography. Tendinosis is diagnosed by palpation, radiography, magnetic resonance imaging and ultrasound examination affected area.
Methods for treating fractures
When the greater trochanter of the femur is fractured, the patient is usually given a circular plaster cast in abduction position for 3 weeks. After the prescribed period, the plaster is removed, and the patient is prescribed a course of massage on the affected area. During this period, the patient can move with the help of crutches, since such a load does not cause him any discomfort or pain.
But in some cases, doctors have to resort to open reduction using bone holders specially designed for such procedures, that is, bone fragments are compared with each other, which ensures better fusion. This procedure is carried out if, when the leg is abducted, it is not possible to set the bone fragments.
Tendinosis therapy
Treatment of this pathology is carried out comprehensive measures. Depending on the location of the lesion and the stage of the disease, the doctor prescribes the optimal therapy. To relieve pain, the patient is prescribed painkillers and ice compresses, which must be applied to the affected area.
With help elastic bandages or bandages, the affected joint is limited in movement. In addition, physiotherapeutic procedures are used to treat tendinosis. Magnetic therapy, laser, ultrasound, for example, have a good effect; applications from healing mud and baths with mineral salts. As recovery progresses, the patient should begin a course of exercise therapy. Exercises help improve joint mobility, elasticity and muscle strength.
Surgery for tendinosis is last resort treatment of this disease and it is used in very rare cases. Doctors are trying to get by conservative methods therapy.
What to do with bursitis?
Treatment of bursitis should begin with simple procedures. Very rarely such a disease requires surgical intervention. Patients under thirty years of age are recommended to reduce the load on the affected joint and take a course rehabilitation therapy, which includes exercises to stretch the muscles of the thighs and buttocks.
Therapy for inflammation of the greater trochanter of the femur involves the use of anti-inflammatory drugs medicines. With the help of such drugs, swelling of the affected joint and pain are effectively relieved. The use of cold, ultrasound, heating and UHF helps to get rid of pain and relieve swelling.
One of the most convenient methods of exposure at home is the use of heat or cold. It is important to remember that cold is applied immediately after an injury, and heat is used when inflammatory processes flowing in chronic form. An experienced physiotherapist will be able to give useful recommendations, using which you can completely restore everything motor functions joint If fluid accumulates in the trochanteric bursa, the patient is recommended to undergo a puncture in order to pump out all the water and send it to the laboratory for analysis.
During this procedure, a small dose of steroid hormones, such as cortisone, is injected into the trochanteric bursa, but this can only be done if the patient does not have any infectious diseases. Hormonal drug quickly relieves inflammation. The effect of the procedure can last for 6-8 months.
Timely consultation with a doctor will help a short time cure all existing disorders in the femur. If any of the pathologies in a given part of the human body acquires chronic course, That pain syndrome only pauses for a while.
The femur (lat. osfemoris) is the largest and longest tubular bone of the human skeleton, serving as a lever of movement. Its body has a slightly curved and axially twisted cylindrical shape, expanded downwards. The anterior surface of the femur is smooth, the posterior surface is rough, serving as a site of muscle attachment. It is divided into the lateral and medial lips, which are close to each other closer to the middle of the femur, and diverge downwards and upwards.
The lateral lip downwards significantly thickens and widens, passing into the gluteal tuberosity - the place to which the gluteus maximus muscle is attached. The medial lip descends lower, turning into a rough line. At the very bottom of the femur, the lips gradually move away, limiting the popliteal surface to a triangular shape.
The distal (lower) end of the femur is slightly expanded and forms two rounded and fairly large condyles, differing from each other in size and degree of curvature. Relative to each other, they are located at the same level: each of them is separated from its “brother” by a deep intercondylar fossa. The articular surfaces of the condyles form a concave patella surface, to which the patella is adjacent with its posterior side.
Femoral head
The head of the femur rests on the upper proximal epiphysis, connecting to the rest of the bone through a neck located at an angle of 114-153 degrees from the axis of the body of the femur. In women, due to the greater width of the pelvis, the angle of inclination of the femoral neck approaches a straight line.
At the borders of the transition of the neck to the body of the femur there are two powerful tubercles, which are called trochanters. The location of the greater trochanter is lateral; on its median surface there is a trochanteric fossa. The lesser trochanter is located below the neck, occupying a medial position in relation to it. In front, both trochanters - the greater and the lesser - are connected by the intertrochanteric ridge.
A fracture of the femur is a condition characterized by a violation of its anatomical integrity. Most often, it happens in older people when they fall on their side. Concomitant factors for hip fractures in these cases are decreased muscle tone, as well as osteoporosis.
Signs of a fracture are sharp pain, swelling, dysfunction and deformation of the limb. Trochanteric fractures are characterized by more intense pain, which intensifies when attempting to move and feel. The main symptom of a fracture of the upper part (neck) of the femur is the “stuck heel symptom” - a condition in which the patient cannot turn the leg at a right angle.
Fractures of the femur are divided into:
- Extra-articular, which, in turn, are divided into impacted (abduction), non-impacted (adduction), trochanteric (intertrochanteric and pertrochanteric);
- Intra-articular, which include fracture of the femoral head and fracture of the femoral neck.
In addition, in traumatology there are the following types intra-articular hip fractures:
- Capital. In this case, the fracture line affects the femoral head;
- Subcapital. The fracture site is located immediately below its head;
- Transcervical (transcervical). The fracture line is located in the femoral neck;
- Basiscervical, in which the fracture site is located at the border of the neck and body of the femur.
If the fractures are impacted, where a fragment of the femur is wedged into another bone, it is practiced conservative treatment: the patient is placed on a bed with a wooden board placed under the mattress, while the injured leg rests on a Beller splint. Next, skeletal traction is performed on the condyles of the leg and thigh.
In case of displaced fractures, characterized by deformation and malposition of the limb, surgery is recommended.
Necrosis of the femur
Necrosis of the femur - serious disease which develops as a result of structural, nutritional or fatty degeneration disorders bone tissue. The main reason pathological process, developing in the structure of the femur - a violation of blood microcirculation, osteogenesis processes and, as a consequence, the death of bone tissue cells.
There are 4 stages of necrosis of the femur:
- Stage I is characterized by periodic pain radiating to groin area. At this stage, the spongy substance of the femoral head is damaged;
- Stage II is distinguished by strong constant pain, which do not disappear at rest. X-ray of the femoral head is dotted with small, as if eggshell, cracks;
- Stage III is accompanied by atrophy gluteal muscles and thigh muscles, there is a displacement of the gluteal fold, shortening of the lower limb. Structural changes are about 30-50%, the person is prone to lameness and uses a cane to move.
- Stage IV is the time when the femoral head is completely destroyed, which leads to disability of the patient.
The occurrence of necrosis of the femur is promoted by:
- Injuries of the hip joint (especially with a fracture of the femoral head);
- Domestic injuries and accumulative overloads received during sports or physical activity;
- Toxic effects of certain drugs;
- Stress, alcohol abuse;
- Congenital dislocation (dysplasia) of the hip;
- Bone diseases such as osteoporosis, osteopenia, systemic lupus erythematosus, rheumatoid arthritis;
- Inflammatory, colds which are accompanied by endothelial dysfunction.
The treatment method for femoral necrosis depends on the stage of the disease, its nature, age and individual characteristics of the patient. To date, there are no drugs that can fully restore blood circulation in the femoral head, so restoration of the organ is most often carried out surgical methods. These include:
- Decompression of the femur - drilling several channels in the head of the femur, inside which blood vessels begin to form and grow;
- Fibula graft transplantation;
- Endoprosthetics, in which the destroyed joint is replaced with a mechanical structure.
The femur or os femoris in Latin is the main element of the human locomotor system. Is different large size and an elongated, slightly twisted shape. A rough line runs along the posterior contour, connecting the hard tissue with the muscles. Due to its structural features, the bone element distributes body weight during movement and also protects joints under increased loads.
Anatomy of the human femur
The shape of the femur bone is elongated and cylindrical, which is why it is called tubular. The body of the link smoothly bends in the upper part and expands in the lower part.
Above, the solid body articulates with the hip joint, below - with kneecap and shin bone. An educational film, the periosteum, is attached to the front side of the tubular material. Thanks to the shell, the growth and development of bone tissue occurs, as well as the restoration of the structure after damage and injury.
The femur gradually increases as the child develops in the womb and ends growth by the age of 25. After which the element ossifies and takes on its final shape.
Lower limb in combination with vascular system, muscles, nerve nodes, connective tissues forms the thigh. Above and in front, the limb is limited by the inguinal ligament, and behind by the gluteal fold. The lower contour extends 5 cm above the patella. The right and left bones have an identical design.
Features of structure and structure
Tubular matter is attached to other parts of the skeleton through joints and ligaments. TO connective tissues muscles are adjacent, nerves and blood vessels are located parallel to the bone. The area where the tendons and tendons meet solid has a tuberous surface, the place of attachment of the arteries is characterized by the presence of grooves.
Like other tubular elements, the femur is divided into three main segments:
- proximal epiphysis - upper sector;
- distal epiphysis - lower part;
- diaphysis - the central axis of the body.
If we examine the structure of the human femur in detail, smaller elements are also visible. Each particle has its own function in the formation of the motor apparatus.
Proximal epiphysis
The upper part of the tubular matter is called the proximal epiphysis. The edge has a spherical, articular surface adjacent to the acetabulum.
There is a hole in the middle of the head. The terminal and central parts of the bone element are connected by a neck. The base is crossed by two tubercles: the lesser and greater trochanters. The first one is inside, with reverse side bones, and the second is palpated through the subcutaneous tissue.
Moving away from the greater trochanter, the trochanteric fossa is located in the neck area. The parts are connected in front by an intertrochanteric line, and on the back side by a pronounced ridge.
Diaphysis
The body of the tubular element has a smooth surface on the outside. By back side The linea aspera passes through the femur. The strip is divided into two parts: lateral and medial.
The lateral lip at the top develops into a tubercle, and the medial lip into a comb strip. On the reverse side, the elements diverge at the distal end, forming the popliteal region.
A channel is laid through the diaphysis with bone marrow where blood cells are formed. Subsequently, mature red blood cells are replaced by adipose tissue.
Distal epiphysis
Bottom part bony body smoothly expands and flows into two condyles: lateral and medial. Along the edge there is a joint that connects the kneecap and the tibia. The terminal part is divided by the intercondylar fossa.
On the side of the articular surface there are notches called the lateral and medial epicondyles. Ligaments are attached to these areas. The adductor tubercle passes over the medial epicondyle, to which the medial muscles are adjacent. The relief can be clearly felt under the skin from the inside and outside.
The pits and elevations on the long bone create a porous structure. Muscle fibers are attached to the surface soft fabrics and vessels.
The femur as the basis of the musculoskeletal system
Solid elements of the skeleton and muscles participate in the formation of the system. The femur and connecting links form the basis for the human frame and internal organs.
The role of thigh muscle tissue
Muscle fibers that are attached to the links of the skeleton are responsible for moving the body. By contracting, the tissues set the human frame in motion. The following are responsible for the activity of the corps:
Muscles of the anterior group:
- quadriceps - participates in flexion of the thigh at the hip joint and extension of the tibia at the knee;
- sartorius - rotates the lower limbs.
Muscles of the back of the thigh:
- popliteal - responsible for activating the knee joint and turning the boot;
- a group of biceps, semimembranosus and semitendinosus tissue - flexes and extends the joints of the thigh and lower leg.
Medial muscle fibers:
- thin;
- comb;
- adductor muscles.
The group moves the hip, rotates, and flexes the lower leg and knee joint.
Functions of the femur
The femur is the connecting link between lower limbs and torso. The element is distinguished not only by its large size, but also by its wide functionality:
- Strong support for the body. By using muscle fibers and connective tissues provide stability to the body on the surface.
- A lever that sets it in motion. Ligaments and a tubular element bring the lower limbs into action: movement, rotation, braking.
- Growth and development. The formation of the skeleton occurs over the years and depends on the correct growth of bone tissue.
- Participation in hematopoiesis. This is where stem cells mature into red blood cells.
- Role in metabolic processes. Accumulate in the structure useful material, carrying out mineralization of the body.
The contraction and strength of muscles depends on how much calcium the bone tissue forms. The mineral is also necessary for the formation of hormones and the proper functioning of the nervous and cardiac systems. When there is a deficiency of calcium in the body, a reserve supply of the microelement from bone tissue comes to the rescue. In this way, an optimal balance of the mineral is constantly maintained.
The lower part of the human skeleton is responsible for body mobility and proper load distribution. Injuries and violations of the integrity of hip tissues lead to dysfunction of the musculoskeletal system.
Damage to bone tissue
The femur can withstand heavy loads, but despite its strength, the structure can break or crack. This is explained by the fact that the element is very long. When falling on a hard object or a directed blow, the bone tissue cannot withstand. Elderly people are especially susceptible to fractures, as skeletal elements become more fragile with age.
The thigh bone is 45 cm long. This is a quarter of the height of an adult. Damage breaks motor activity and limits body functions.
Factors that increase the likelihood of fracture:
- osteoporosis - decreased density of hard tissue;
- arthrosis - damage to bone and joint areas;
- muscle hypotonicity - weakening of fiber tension;
- violation of control over the body - the brain does not send signals;
- bone cyst - benign education similar to a tumor.
Mature women are more likely to experience trauma. This is explained by the peculiarity of the structure of the skeleton. Unlike the male femur, the female femur has a thin neck. In addition, women are more often exposed to these diseases.
Damage diagnostics
If the integrity of the bone tissue is violated, a person feels severe pain, weakness and difficulty moving. Syndromes worsen when open fractures, if the broken edge has damaged the muscles and skin layers. Severe injury is accompanied by blood loss and painful shock. In some cases, an unsuccessful fall leads to death.
Classification of bone fractures depending on the location of the injury:
- deformation of the upper part;
- injury in the diaphysis of the femoral element;
- violation of the distal or proximal metaepiphysis.
Diagnosis of the case and severity is made using an X-ray machine. The bone neck is most susceptible to fracture. This type of injury is called intra-articular. Periarticular disruption in the lateral region is also common.
Severe trauma sometimes occurs without fractures. In this case, you should not exclude the possibility of cracks. An x-ray will clarify the situation. Minor deformation also requires treatment, as it can develop further. In addition, cracks cause bone calluses and make movement difficult. Therapy is prescribed by a traumatologist depending on the clinical picture.
The structure of the femur appears to be complex. the main role tubular matter - distribute the load and balance of the body. The components of the hips are involved in the motor process and connect the pelvis with the lower limbs. It is necessary to take care of the health and strength of bones to avoid cracks and fractures.
Trauma can immobilize a person, and full recovery takes from 2 to 6 months.
Anatomically, the head of the femur is held by the annular glenoid fossa. The femur is considered the largest bone in the body; it has a complex structure. It is not easy for a person far from medicine to understand this, but to understand the causes and characteristics of the course of diseases of the femur, it is necessary.
Anatomy of the femur
If you look at the femur not from scientific point From a layman's perspective, you can see that it consists of a cylindrical tube, expanding towards the bottom. On the one hand, one round head of the femur (proximal epiphysis) ends the bone, on the other hand, two round heads of the femur or distal epiphysis of the femur.
The surface of the bone at the front is smooth to the touch, at the back it has a rough surface, as it is the site of muscle attachment.
Proximal epiphysis of the femur
This top part bone (femoral head) that connects to the pelvis via the hip joint. The articular head of the proximal femur has a rounded shape and is connected to the body of the bone by the so-called femoral neck. In the area where the femoral neck meets the tubular bone there are two tubercles, which in medicine are called trochanters. The skewer located above is larger than the one located below and can be felt under the skin. The intertrochanteric line is located in front between the greater and lesser trochanters, behind them is the intertrochanteric ridge.
Distal epiphysis of the femur
This is the lower section of the bone, wider than the upper, located in the knee area, it is represented by two rounded heads called condyles. They can be easily felt in front of the knee. Between them is the intercondylar fossa. The condyles function as a connection between the femur and the tibia and patella.
Epiphesiolysis
The concept of epiphesiolysis combines fractures of the growth plate of bone. The disease affects children and adolescents, since at their age the growth zone of the bone has not yet closed. There is also the concept of osteoepiphysiolysis, in which a fracture affects the body of the bone.
Juvenile epiphesiolysis of the femoral head
Juvenile epiphysiolysis of the femoral head occurs during puberty in a child (in girls it occurs from ten to eleven years, in boys from thirteen to fourteen). It can affect one joint or both. Moreover, in the second joint the disease manifests itself 10-12 months after the first joint is affected.
It manifests itself as a displacement of the head of the epiphysis in the growth zone, the head seems to slide down into correct position The head of the femur is adjacent to the articular capsule.
If juvenile epiphysiolysis of the femoral head occurs as a result of injury, it will manifest itself with the following characteristic symptoms:
- Pain that increases with exertion.
- A hematoma may appear at the site of injury.
- Edema.
- Leg mobility is limited.
If the disease occurs as a result of bone pathology, then it manifests itself with the following symptoms:
- Periodic pain in the joint may appear and disappear within a month.
- Lameness not associated with injury.
- The affected leg cannot support body weight.
- The leg is turned outward.
- Shortening of the limb.
A doctor can make a diagnosis based on an x-ray.
Important! Undiagnosed and untreated epiphysiolysis leads to early development arthritis and osteoarthrosis of the joint.
Once the diagnosis is confirmed, treatment should begin immediately. If surgery is required, it is scheduled for the next day.
The doctor selects treatment tactics based on the severity of the disease. This disease is treated with the following methods:
- The femoral head is fixed surgically with 1 screw.
- Fixing the head with several screws.
- The growth plate is removed and a pin is installed, which prevents further displacement.
The problem with this disease is that the child is admitted to the hospital late, when the deformity is visible to the naked eye.
Distal epiphysis of the femur
Occurs in the knee joint in the growth zone as a result of the following actions:
- sharp rotation in the knee;
- sharp bending;
- hyperextension in the knee joint.
- Deformation of the knee joint.
- Hemorrhage in the knee joint.
- Limitation of leg movement at the knee joint.
If epiphysiolysis is detected in time, the joint can be reduced without opening. In advanced cases, surgical intervention is required.
Important! Mothers of boys aged 7 years and older should carefully monitor their child’s gait, as initial stage This disease is manifested by lameness.
The prognosis of the disease depends on its severity. In the most severe cases joint deformation occurs and limb growth slows down.
Decentration of the femoral heads
Decentration of the femoral head is a displacement, sliding of the articular heads of the bones from the acetabulum due to a discrepancy between the sizes of the cavity and the joint. Otherwise known as hip dysplasia. This congenital disease which can cause hip dislocation. Manifests itself with the following symptoms:
- Restriction when spreading the hips to the sides, while a kind of click is heard.
- Asymmetry of inguinal and gluteal folds.
- Shortening the leg.
When examining a child in the maternity hospital, the neurologist first checks hip joints child. If dysplasia is suspected, the child is sent for an ultrasound. This type of diagnosis is preferable for children under 1 year of age.
Treatment of dysplasia should begin from the very first days of diagnosis. Undiagnosed and untreated dysplasia leads to joint problems in adulthood, for example, dysplastic coxarthrosis.
Cyst-like reconstruction of the femoral head
Cyst-like restructuring is manifested by the growth of bone tissue around the edge of the glenoid cavity, which leads to displacement of the femur, resulting in hip subluxation.
Manifested by the following symptoms:
- joint pain;
- restriction of movement;
- soft tissue atrophy;
- shortening of limbs.
It is diagnosed using an x-ray, which usually clearly shows bone growths.
This disease has many subtypes, so accurate diagnosis must be determined by the attending physician. It can be written along with a list of further necessary treatment on a separate page, which is given to the patient.
The femur is very important element V skeletal system person. In order to warn various diseases associated with it, the musculoskeletal system should be strengthened from childhood.
Femur (femur).
A-front surface; B-posterior surface; B-patella.
A: 1-great trochanter;
2-trochanteric fossa;
3-head of the femur;
4-neck of the femur;
5-intertrochanteric line;
6-small trochanter;
7-body of the femur;
8-medial epicondylocus;
9-medial condyle;
10-patellar surface;
11-lateral condyle;
12-lateral epicondyle.
B: 1-lmka of the femoral head;
2-head of the femur;
3-neck of the femur;
4-large skewer;
5-gluteal tuberosity;
6-lateral lip of the linea aspera;
7-body of the femur;
8-popliteal surface;
9-lateral epicondyle;
10-lateral condyle;
11-intercondylar fossa;
12-medial condyle;
13th medial epicondyle;
14-adductor tubercle;
15-medial lip of the linea aspera;
16-comb line; 17-lesser trochanter;
18-intertrochanteric ridge.
IN; 1-base of the patella;
2-front surface.
3-apex of the patella.
The femur, femur, is the largest and thickest of all the long bones. tubular bones. Like all similar bones, it is a long lever of movement and has a diaphysis, metaphyses, epiphyses and apophyses according to its development. The upper (proximal) end of the femur bears the round articular head, caput femoris (epiphysis), slightly down from the middle on the head there is a small rough pit, fovea captits femoris, - the place of attachment of the ligament of the head of the femur. The head is connected to the rest of the bone through the neck, collum femoris, which stands to the axis of the body of the femur at an obtuse angle (about 114-153°); in women, depending on the greater width of their pelvis, this angle approaches a straight line. At the junction of the neck and the body of the femur, two bony tubercles, called trochanters (apophyses), protrude. The greater trochanter, trochanter major, represents the upper end of the body of the femur. On its medial surface, facing the neck, there is a fossa, fossa trochanterica.
The lesser trochanter, trochanter minor, is located at the lower edge of the neck on the medial side and somewhat posteriorly. Both trochanters are connected to each other on the posterior side of the femur by an obliquely running ridge, crista intertrochanterica, and on the anterior surface - linea intertrochanterica. All these formations - trochanters, ridge, line and fossa are caused by muscle attachment.
The body of the femur is slightly curved anteriorly and has a trihedral-rounded shape; on its back side there is a trace of the attachment of the thigh muscles, linea aspera (rough), consisting of two lips - the lateral one, labium laterale, and the medial one, labium mediale. Both lips in their proximal part have traces of attachment of the homonymous muscles, the lateral lip is tuberositas glutea, the medial lip is linea pectinea. At the bottom, the lips, diverging from each other, limit a smooth triangular area on the back of the thigh, facies poplitea.
The lower (distal) thickened end of the femur forms two rounded condyles that wrap back, condylus medialis and condylus lateralis (epiphysis), of which the medial one protrudes more downward than the lateral one. However, despite this inequality in size of both condyles, the latter are located at the same level, since in its natural position the femur stands obliquely, and its lower end is located closer to midline than the top one. On the anterior side, the articular surfaces of the condyles pass into each other, forming a small concavity in the sagittal direction, facies patellaris, since the patella is adjacent to it with its posterior side during extension in the knee joint. On the posterior and inferior sides, the condyles are separated by a deep intercondylar fossa, fossa intercondylar. On the side of each condyle above its articular surface there is a rough tubercle called epicondylus medialis medial condyle and epicondylus lateralis in the lateral one.
Ossification. On x-rays At the proximal end of the femur of a newborn, only the femoral diaphysis is visible, since the epiphysis, metaphysis and apophyses (trochanter major et minor) are still in the cartilaginous phase of development.
The X-ray picture of further changes is determined by the appearance of a ossification point in the head of the femur (epiphysis) in the 1st year, in the greater trochanter (apophysis) in the 3rd-4th year and in the lesser trochanter in the 9th-14th year. The fusion goes to reverse order aged 17 to 19 years.
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