Femur . Long, even and asymmetrical bone, which constitutes by itself the skeleton of the second segment of the pelvic limb. Considered in a skeleton in a vertical position, the femur is directed obliquely from top to bottom and from outside to inside, so that the two femurs, very close to each other at their lower end, are separated at the top by all the distance between the two colloid cavities . The axes of the femurs form an angle of 8 or 9 °, their obliqueness being more pronounced in women than in men, depending on the conformation of their pelvis.
On the other hand, the body of the bone is curved on itself, so it has the shape of an arch whose concavity faces backwards. Finally, the femur presents a slight twist on its vertical axis, which makes the transverse plane of its upper end not entirely parallel to the transverse plane of its lower end. Like all long bones, the femur has a body and two limbs, one upper and one lower. The body of the femur is triangular prismatic, considering three faces and three edges.
Summary
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- 1 Features
- 1 Anterior face
- 2 External face and internal face
- 3 Internal and external edges
- 4 Rear edge
- 5 Head of the femur
- 6 Joint head
- 7 Anatomical neck
- 8 Greater trochanter
- 9 Minor Trochanter
- 10 Surgical neck
- 11 Bottom end
- 2 fracture
- 1 Types of fracture
- 3 Sources
characteristics
Previous face
The anterior face, smooth and more convex than flat, is covered, in its three upper quarters, by the femoral muscle or deep part of the Quadriceps , to which it inserts. Below the crural muscle, this face also provides insertion to the subcrural or tensor synovial muscle of the knee.
External face and internal face
The external face and the internal face are convex and smooth; Wide in its upper two thirds, they narrow and end in a point in its lower extremity, as a consequence of the bifurcation of the posterior edge of the bone and the formation of the popliteal triangle. The femoral muscle slightly covers the two faces and is inserted in them, mainly in the external one. Frequently in the middle third of this external face, and near the rough line, a shallow, but quite extensive, longitudinal depression is seen, corresponding precisely to the insertions that the outermost bundles of muscle take in this region of the bone body
Inner and outer edges
The inner and outer edges are very poorly marked so that the faces described above do not have well defined boundaries
Rear edge
This thick, protruding and rough edge perfectly separates the outer face from the inner face. This edge is known by the special name of rough femur line. Its external lip serves as an insertion point for the vastus exterior and its internal lip provides an insertion for the vastus internus. In its interstitium, the three adductor muscles of the thigh and the short portion of the biceps are inserted successively, from top to bottom. The rough line is divided, at its two extremities, into multiple branches. At the bottom, it forks following a highly divergent path, each of which ends at the two eminences or condyles of the lower extremity of the bone. In this way, they delimit an extensive triangular surface with a lower base, known as the popliteal space or popliteal triangle. Above, the rough line is divided into three branches: the external branch, which is always the most marked, is directed upwards towards the greater trochanter, and provides insertion to the gluteus maximus; it is the gluteal branch or crest of the gluteus maximus; the middle branch, located inside the preceding one, is directed towards the lesser trochanter and provides insertion to the pectineal muscle, being called the pectineal crest; the internal branch comes to an end in the anterior and inferior part of the neck, and the internal vastus of the crural quadriceps (crest of the internal vastus) is partially inserted in it. In the rough line and at a point next to its superior division is the nourishing hole of the femur it is directed towards the lesser trochanter and lends insertion to the pectineus muscle, being called the pectineal crest; the internal branch comes to an end in the anterior and inferior part of the neck, and in this part the internal vastus of the crural quadriceps (crest of the internal vastus) is partially inserted. In the rough line and at a point next to its superior division is the nourishing hole of the femur it is directed towards the lesser trochanter and lends insertion to the pectineus muscle, being called the pectineal crest; the internal branch comes to an end in the anterior and inferior part of the neck, and in this part the internal vastus of the crural quadriceps (crest of the internal vastus) is partially inserted. In the rough line and at a point next to its superior division is the nourishing hole of the femur
Head of the femur
It is made up of the articular head, the anatomical neck, the surgical neck and between the two necks, two bulky tuberosities that are designated with the names of the greater trochanter and lesser trochanter.
Articular head
Regularly rounded, it represents approximately two thirds of a sphere. Look up, in and a little forward. Slightly below and behind its center, this head has a rough depression, called a round ligament fosilla intended for insertion of the round ligament of the hip joint . Five or six vascular holes are ordinarily seen in this pit, always highly variable due to their location and dimensions.
Anatomical neck
The anatomical neck or simply the neck of the femur supports the head and connects it to the trochanters. It is shaped like a highly flattened cylinder from front to back. Its major axis, which represents its length, has an oblique direction from top to bottom and from the inside to the outside and measures 35 to 45 millimeters in length. Make an angle of 130 ° with the axis of the body of the bone. Its vertical diameter, which represents its height, is slightly oblique down and behind, from which it turns out that the front of the neck looks down a little and its back up a little.
Greater trochanter
It is a quadrilateral eminence located on the outside of the neck, in the direction of the body of the bone; it is considered two faces and four edges. The external face is crossed diagonally by a rough line called the crest of the gluteus medius. Above it is a small flat surface, occupied in a fresh state by a serous pouch, intended to favor sliding of the gluteus medius tendon. Beneath it there is another, much larger surface on which the serous pouch of the gluteus maximus is housed. The internal aspect of the greater trochanter (*) is almost entirely confused with the external extremity of the neck. However, it emerges from it in its posterior part and at this site it presents a deep depression, known as the trochanteric fossa in which the external obturator is inserted, the internal shutter and the two terms. The four edges of the greater trochanter are distinguished into superior, inferior, anterior, and posterior. The upper edge, almost horizontal, presents in its middle part a small facet, round or oval, for the insertion of the pyramid.
The lower edge continues with the body of the bone; It is externally marked by a rough crest, slightly obliquely directed, in which some of the bundles of the external vastness come to be fixed: it is the crest of the external vastus. The posterior border, perfectly marked above, where it constitutes the posterior limit of the digital cavity, appears less clean in its lower part, where it provides insertion to the upper bundles of the square femoral muscle. The front edge, very thick and rectangular in shape, reaches almost the dimensions of a true face: it is occupied by the insertion roughnesses of the gluteus minimus, traces that partly reach the upper edge of its upper extremity.
Lesser trochanter
The lesser trochanter is a thick tubercle located at the back and bottom of the neck; lends insertion to the Psoasiliac muscle . The lower edge of the neck, the posterior intertrochanteric ridge, and the femoral crest of the pectineum depart from the base of the lesser trochanter. Ahead, the lesser trochanter is separated from the anterior intertrochanteric line by a shallow and more or less rough depression, into which the bundle of the iliofemoral ligament is inserted.
Surgical neck
The portion of the femur that joins the body of the bone to its upper end and corresponds immediately below the trochanters is called the surgical neck.
Lower end
At its lower end, the femur widens transversely and anteroposteriorly, thus forming a bulky mass, irregularly cubic in shape. Furthermore, it curves slightly from front to back, so that the longitudinal axis of the bone body, extended downwards, divides the lower end into two very unequal portions, the posterior portion always being much larger than the anterior. Viewed from the front, the lower end of the femur presents above all a pulley-shaped articular surface, called the femoral trochlea: it is formed. Like all Trochlea, by two lateral facets, which lean towards each other, verging on an anteroposterior groove or throat of the trochlea. The pulley throat extends into a wide notch that divides the lower end of the femur into two lateral portions called condyles. For this reason, it is called an intercondylar notch or fossa.
The two condyles are distinguished in internal and external. The inner condyle is less thick than the outer condyle, but protrudes much more inward than the outer condyle outwards. Further. the external condyle descends less than the internal one, which means that if both condyles are placed on one plane, the femur takes an oblique direction up and out. Each condyle has six faces: upper face that forms a body with the bone; lower face, anterior and posterior face, these last three articular and arranged in a semicircle, to roll over the tibia; medial aspect that is part of the intercondylar space and provides insertion to the cruciate ligaments; and finally, lateral or cutaneous face. The two regions are also located at the lower end of the femur: ahead is a slightly excavated surface, called supratrochlear hollow, in which the patella lodges in the movements of extension of the leg on the thigh. Behind and above the intercondylar notch extends the widest portion of the popliteal space.
Fracture
The femur fracture is an extremely painful injury that prevents the person from being able to move normally, since the pain is extremely intense. The femur is the bone of the hip joint, so its break affects all movement in this area of the body. Surgical intervention should be carried out as soon as possible to alleviate the ailment, where depending on the type of surgery will be the recovery and the rehabilitation period. Generally, fracture of the femur occurs in elderly people, as a result of falls due to loss of stability or due to not being able to support their own weight, but it can happen at any age, other than the most common cases.
The group of people who are most exposed to this type of injury are Women over 50 years of age who are overweight or underweight. In the same way that it happens with fractures of the ankle, wrist, elbow, pelvis, patella and many other areas of the human body, the Hip Fracture is fully confirmed by the plates that result from X-rays. Smoking, sedentary lifestyle and alcoholism are factors that further favor this type of problem, factors that added to the lack of calcium in the bones make a fracture of this nature happen more frequently. These fractures can be separated into two groups:
- Intracapsular or medial, fractures that occur in the neck of the femur.
- Extracapsular or lateral, directly affect the trochanterian massif.
Types of fracture
The distal hip fracture is the one that is most commonly generated in athletes, as a result of a strong blow in this area. It also happens in car accident cases, where a blow to the hip can cause a fracture at the distal end of the radius or a Colles fracture. The injuries that can happen are varied, the most common cases that appear are the following: – Middle fracture of the neck of the femur – Lateral fracture of the neck of the femur – Pertrochanteric fracture of the femur – Subtrochanteric fracture of the femur – Fracture of the body of the femur – Fracture of the head of the femur – Fracture of the greater trochanter – Fracture or detachment of the lesser trochanter. In many cases it has been found that these fractures can happen in newborn babies,
