Greater trochanter of the femur: anatomy. Large femur

Anatomically, the femoral head is held by the annular glenoid fossa. The femur is considered the largest in the body, it has a complex structure. It is not easy for a person who is far from medicine to understand this, but it is necessary to understand the causes of the onset and characteristics of the course of diseases of the femur.

Anatomy of the femur

If you look at the femur not from a scientific point of view, but from a philistine one, you can see that it consists of a cylindrical tube, expanding towards the bottom. On the one hand, one round femoral head (proximal epiphysis) completes the bone, on the other hand, two rounded femoral heads or distal femoral epiphysis.

The surface of the bone in front is smooth to the touch, but behind it has a rough surface, as it is the place of muscle attachment.

Proximal epiphysis of the femur

This is the upper part of the bone (femoral head) that connects to the pelvis through 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 of the transition of the femoral neck to the tubular bone, there are two tubercles, which in medicine are called skewers. The spit that is located on top is larger than that located below and can be felt under the skin. The intertrochanteric line is in front between the greater and lesser trochanters, behind them is the intertrochanteric crest.

Distal epiphysis of the femur

This is the lower section of the bone, wider than the upper one, located in the area of the knee, it is represented by two rounded heads called condyles. They are easily palpable in front of the knee. Between them is the intercondylar fossa. The condyles serve to connect the femur to the tibia and patella.

epithesiolysis

The concept of epifesiolysis combines fractures of the growth plate of the 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 osteoepiphyseolysis, in which the fracture affects the body of the bone.

Juvenile epithesiolysis of the femoral head

Juvenile epiphysiolysis of the femoral head occurs during puberty in a child (in a girl it occurs from ten to eleven years old, 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 defeat of the first joint.

It is manifested by a displacement of the head of the epiphysis in the growth zone, the head, as it were, slides down, in the correct position, the head of the femur adjoins the articular bag.

If juvenile epiphyseolysis of the femoral head occurs as a result of an injury, it will manifest itself with the following characteristic symptoms:

Pain that worsens with exertion.
A hematoma may appear at the site of injury.
Edema.
Leg mobility is limited.

If the disease has arisen due to bone pathology, then it manifests itself with the following symptoms:

Periodic pain in the joint, can either occur or disappear within a month.
Lameness not related to injury.
The affected leg cannot support the weight of the body.
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 the early development of arthritis and osteoarthritis of the joint.

Once the diagnosis is confirmed, treatment should begin immediately. If an operation is required, it is scheduled for the next day.

The doctor selects the tactics of treatment based on the severity of the disease. This disease is treated by the following methods:

The femoral head was fixed surgically with 1 screw.
Fixing the head with a few screws.
The growth plate is removed and a pin is installed, which prevents further displacement.

The problem of this disease is that the child enters the hospital late, when the deformation is visible to the naked eye.

Distal epiphyseolis 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.

Deformity of the knee joint.
Hemorrhage in the knee joint.
Restriction of movement of the leg in the knee joint.

If the epiphysiolysis is detected in time, it is possible to do with the reduction of the joint without opening. In advanced cases, surgery is required.

Important! Mothers of boys over the age of 7 should carefully monitor the child's gait, as the initial stage of this disease is manifested by lameness.

The prognosis of the disease depends on its severity. In the most severe cases, deformity of the joint occurs, and the growth of the limb slows down.

Decentration of the femoral heads

Decentration of the femoral head is a displacement, slippage of the articular heads of the bones from the acetabulum due to a discrepancy between the size of the cavity and the joint. Otherwise it is called hip dysplasia. This is a congenital disease that can cause hip dislocation. It manifests itself with the following symptoms:

Restriction when breeding the hips to the sides, while a kind of click is heard.
Asymmetry of the inguinal and gluteal folds.
Leg shortening.

When examining a child in the maternity hospital, the neuropathologist first of all checks the hip joints of the child. If dysplasia is suspected, the child is sent for an ultrasound. This type of diagnosis is preferred for children under 1 year old.

Treatment of dysplasia should begin from the very first days of diagnosis. Undiagnosed and untreated dysplasia leads to joint problems in adulthood, such as dysplastic coxarthrosis.

Cystic remodeling of the femoral head

Cystic restructuring is manifested by the growth of bone tissue around the edge of the articular cavity, which leads to displacement of the femur, as a result of which subluxation of the hip occurs.

It manifests itself with the following symptoms:

joint pain;
movement restriction;
soft tissue atrophy;
limb shortening.

Diagnosed by x-ray, which usually clearly shows bone growths.

This disease has many subspecies, so an accurate diagnosis should be made by the attending physician. It can be recorded along with a list of further necessary treatment on a separate page, which is given to the patient in the hands.

The femur is a very important element in the human skeletal system. In order to prevent various diseases associated with it, it is necessary to strengthen the musculoskeletal system from childhood.

- the upper part of the lower limb, the area between the pelvis and the knee. The muscles passing in this area control the hip and knee joints, therefore they are called biarticular:

The volume of the front part and the strength of the thigh is given by the quadriceps muscle - the main extensor of the knee. For example, when walking or when playing football. She also performs hip flexion.
A group of flexors runs along the back, which has other functions in relation to the pelvic region - it promotes extension.

Therefore, the thigh bones form two large joints of the lower limb.

Where is it located and what does it consist of?

The photo shows that the thigh is limited to the inguinal ligament in front and the gluteal folds in the back. The area ends 5 cm above the knee.

It includes the longest bone that forms two joints - the knee and the hip. The contraction of the thigh muscles is provided by nerves from the lumbar plexus.

Next to them lie the arteries that supply blood to the bones, muscles, and skin. Veins take blood, providing outflow from the lower extremities. Trophic supply passes through the tendon canals. The thigh area contains lymph nodes and blood vessels.

Bones

The structure of the femur (femur) allows you to find out the places of muscle attachment. The tubular bone that forms the skeleton of the thigh occupies about a quarter of a person's height.

For example, the right femur deviates in shape to the left or inward relative to the pelvis to enter the knee, and is cylindrically expanded downwards. Most of the large muscles are attached to the proximal ends of the lower leg.

At the top, the head of the femur enters the acetabulum of the hip joint. The body and head are connected by the neck at an angle of 130 degrees to the axis of the bone itself. In the female pelvis, the angle is close to a straight one, which affects the width of the hips, while in men, the angle is wide. Below, at the transition to the body, the bones stand out into the greater and lesser trochanters:

large - this is a palpable protrusion on the lateral surface of the thigh directly under the pelvis;
small - located inside and backwards, therefore it is not palpable.

A trochanteric fossa is formed between them. The tubercles are connected by an intertrochanteric line in front and a crest behind. At the top of the head in a rough fossa, a ligament of the same name is attached.

The main anatomical landmark of the posterior surface is a rough line running through the center. On the sides it has ridges called lips:

the lateral (or external) expands and forms the gluteal tuberosity, where the attachment point of the gluteus maximus muscle is located, and from below it connects to the condyle;
medial (or internal) - in the upper part it has a comb line for attaching the muscle of the same name, and in the lower part it passes into the condyle.

For the right femur, the medial condyle or protrusion is on the left and the lateral is on the right. From them come the supracondylar lines, forming the popliteal region.

The femur is equipped with a nutrient hole - a channel for the exit of nerves and blood vessels. The listed anatomical landmarks serve to attach the muscles.

muscles

Conventionally, the muscles of the thigh are divided into three groups. The muscles of the anterior part are responsible for knee extension and hip flexion:

Lumbar- the main flexor, the step starts from it. Attaches to all lumbar and last thoracic vertebrae, ends at the lesser trochanter of the thigh. The function depends on the nerves of the first three lumbar vertebrae. With her weakness, the pelvis moves forward, a stoop is formed - the pose of a teenager.
Rectus femoris It's a knee stabilizer. It comes from the lower edge of the iliac spine in front and the supraacetabular groove. At the patella, it connects to its ligament and reaches the tibial tuberosity. Included in the anterior superficial myofascial chain - involved in the forward tilt. Without diaphragmatic breathing - expansion of the ribs to the sides - muscle function is impaired. Nutrition - the lateral artery, enveloping the femur.
Intermediate wide lies from the intertrochanteric line to the tibia. Affects the joint capsule.
medial wide- descends from the same edge of the lip of the rough line to the lower leg. It is innervated by the muscular branches of the femoral nerve, which emerges from the roots of the 2nd, 3rd and 4th lumbar vertebrae.
Lateral wide- from the greater trochanter and intertrochanteric line stretches along the lateral lip of the rough line - stabilizes the joint from the outside. Same innervation.
Tailoring- descends from the upper part of the ilium and, bending around the thigh, reaches the upper medial edge of the tibia. With her hypotension, valgus of the knee will develop, the pelvic bone on the sides of hypotension falls and topples back.

Five adductors (adductor muscles) on the medial part stabilize the hip in the step, preventing it from deviating to the side:

Large adductor, the largest of the group, is functionally divided into two parts: adductor - goes from the pubic and ischial bones to the rough line; posterior - from the tuberosity of the ischium to the adductor tubercle and the internal supracondylar line. Brings legs together, participates in hip flexion. The posterior fibers are involved in its extension. Innervated by the obturator nerve and the tibial branch of the sciatic nerve. Turns the limb outward. Therefore, it is erroneous to assume that with valgus it is necessary to stretch it, on the contrary, it is weak.
long adductor covers the fibers of other adductor muscles - short and large, along the outer edge of the femoral triangle. From the pubic bone it expands like a fan to a rough line. Performs adduction and external rotation of the femur, innervated by the obturator nerve.
short adductor passes under the long one from the pubic bone and its lower branch to the rough line. It also adducts, rotates outward, and flexes the hip.
Comb- stretches from the pubic bone and its crest to the area between the lesser trochanter and the rough line. Therefore, when contracting, it bends the hip joint and turns the leg outward. The area often hurts while walking when the iliopsoas muscle is affected.
Thin- the most superficial muscles, crosses both joints. From the pubic bone and symphysis descends to the inner edge of the tibia, between the tailor and semitendinosus. Adducts limb and flexes knee.

The muscles of the posterior group form powerful tendons under the knee region. They extend the hip joint and flex the knee. They are innervated by the sciatic nerve, which emerges from the vertebrae L4-S3 - the last two lumbar and three sacral.

Each type of muscle has its own role:

two-headed- stretches along the outer edge of the thigh. The long head comes from the ischial tuberosity, and the short head comes from the rough line. The tendon formed by them is fixed on the head of the fibula. Flexes the knee, extends the hip, and rotates the femur outward. With weakness, valgus deformity is formed. The long head is innervated by the tibial part of the sciatic nerve, and the short head by the common peroneal. With flat feet, the function of this flexor suffers.
Semitendon lies on the inside and intersects with the semimembranous. It starts on the ischial tuberosity and ends on the inside of the tibia, therefore it flexes the knee, extends the thigh. Its fibers turn the leg and knee inward. Nerve impulses come from the sciatic nerve.
Semimembranous- a thin and stretched in width muscle located under the semitendinosus. It starts on the ischial tuberosity and ends on the medial tibial condyle. Flexes the knee and extends the hip joint, rotates the limb inward. With the weakness of the last two muscles, varus deformity of the knee occurs.

All muscles enter the posterior myofascial chain along with the extensors of the spine, calves.

Vessels

The tissues are fed by the femoral artery, which emerges from the groin. Its branches supply blood to the muscles of the anterior and inner thighs, genitals, skin, lymph nodes, and bone.

The vessel lies between these two muscle groups, passes into the femoral triangle. Further, above the comb muscle, it descends into the gunter's canal. With prolonged sitting, it is often pinched by the flexor muscles and the inguinal ligament.

A branch departs from it - the deep artery of the thigh three centimeters below the inguinal ligament, above the iliopsoas and pectineus muscles. When sitting, squatting and anterior tilt of the pelvis, muscle fibers can compress the vessel.

From the deep artery of the thigh depart branches that envelop the femur:

medial blood supply to the medial broad muscle;
the lateral with its lower branch passes under the tailor, straight to the intermediate and lateral broad muscle of the thigh.

The perforating arteries, departing from the deep artery of the thigh, pass to the posterior surface below the pectineus muscle. They nourish the adductor muscles, knee flexors, and also the skin. Therefore, prolonged sitting, spasm of the iliopsoas muscle leads to starvation of the tissues of the lower limb as a whole.

The vessels and nerves of the thigh pass in the fascial canals along with the veins, forming neurovascular bundles.

Nerves

The performance of the hip depends on the health of the sacrum. From its roots, as well as the last two vertebrae of the lumbar plexus, two important nerves emerge:

Femoral- passes under the inguinal ligament, innervates the muscles of the anterior thigh group.
obturator- passes through the membrane of the same name in the opening of the pelvic bone to the adductor muscles.
Sciatic- comes out of the sacrum and lower back - to the flexors.

The femoral nerve may be pinched by spasmodic fibers of the lumbar and inguinal ligaments. When passing through the pelvis to the thigh, there is a division into the anterior and posterior sections.

The sciatic nerve exits the pelvic cavity through the greater sciatic foramen under the piriformis muscle and innervates the back of the thigh. With its weakness, the nerve is pinched, sciatica develops.

The obturator (obturator) nerve exits the obturator foramen through the canal of the same name. The condition of the adductor muscles, the capsule of the hip joint and the periosteum of the thigh depends on it.

It is often compressed by the psoas, sacroiliac joint, sigmoid colon, or inflamed appendix at the level of the membrane and with long hip flexion.

Conclusion

The thigh is made up of bone, several muscle groups that provide leverage to the hip and knee joints.

No muscle works in isolation in daily activities, as all muscles are connected by nerves, blood vessels and connective tissue - fascia. If one part of the thigh is damaged, the biomechanics of the movement of the pelvis, trunk, shoulders, and feet will change.

In contact with

The human skeleton consists of many components, the main of which is the femur. She is responsible for maintaining the body and plays the role of a motor lever. It is based on multiple elements that allow you to make smooth movements.

The femur holds the weight of a person and takes an active part in motor processes. The main functions of the element of the musculoskeletal system are performed due to the unique structure. Anatomical features allow you to move freely, and at the same time protect the joints from excessive stress.

The structure of the femur is quite simple. It is based on cylindrical structures that expand towards the bottom. Behind is a special surface, characterized by the presence of a rough line. It has a tight relationship with the muscles of the leg. The head of the femur is located on the proximal epiphysis. It is characterized by the presence of an articular surface, the main function of which is the articulation of the bone with the acetabulum.

Exactly in the middle is the fossa of the femoral head. It is connected to the body of the main element by means of a neck. Its feature is the location at an angle of 130 degrees. The femoral neck is located near two tubercles, which are called skewers. The first element is located near the skin, which makes it easy to feel. This is the lateral trochanter, which is connected to the second tubercle through the intertrochanteric line. From the back, the intertrochanteric crest is responsible for performing the functions.

The trochanteric fossa is located near the femoral neck. The tuberosity of the structure allows the muscle to freely attach to the bone element. The lower end of the bone is somewhat wider than the upper, while the transition is smooth. This effect is achieved due to the unique arrangement of the condyles. Their main function is the articulation of the tibia with the patella.

The radius of the condyle decreases posteriorly, giving the element a spiral shape. Its lateral surfaces are characterized by the presence of protrusions. Their function is to attach ligaments. These elements are easily palpable through the skin.

Anatomy of the femur

The anatomy of the femur is complex. The support element is based on components that ensure reliability during movement. The right and left bones do not have any special differences, while they are characterized by the same structure and functional features.

Features and structure

The femur has a special structure. It is based on the body and two epiphyses, proximal and distal. The anterior femoral surface is smooth, with a rough line on the posterior part. It divides the entire area into two main lips, lateral and medial. The first type captures the lateral condyle and goes to the side. The lip from the upper part passes into the gluteal tuberosity.

The second type passes through the medial section, descending to the lower part of the femur. In this place, the restriction of the popliteal region is fixed. This surface is additionally limited on the sides by two vertical lines, medial and lateral.

The medial lip and the comb line are characterized by the presence of a smooth transition. In the middle of the bone there is a special nutrient hole, which has special functions. The comb line is responsible for feeding the channel. Many vessels pass through the hole. In the upper epiphysis there are two main trochanters, large and small. The first type is the attachment point of the gluteal muscles, and the second is responsible for hip flexion.

The greater and lesser trochanters play an important role in the anatomy of the femur. From the outside, they can be felt through the skin. On the upper surface, the skewer is characterized by the presence of a fossa. The intertrochanteric line smoothly passes into the comb area. On the back of the upper epiphysis is a ridge that ends at the lesser trochanter. The rest is the ligament of the femoral head. This area is often damaged by fractures. The neck ends with a head, there is a fossa on the surface.

The anatomy of the distal pituitary gland practically does not differ from the proximal one. It is based on the medial and lateral condyle. The first type contains the epicondyle on the inner surface, and the second - on the outer site. A little higher is the adductor tubercle. The adductor muscle is attached to it.

The anatomical features of the structure of human bones are complex due to the functions performed. The lower part of the skeleton is responsible for the mobility of the limbs. Any deviations affect the functional features of the femur.

Common bone injuries

Damage to the supporting element affects the motor activity of a person. Injuries of this type are common, due to force majeure situations and age-related changes. In most cases, fractures are observed, leading to loss of anatomical integrity. The reasons why this happens are many. The resulting injury damages the lower part of the motor apparatus. The person feels bad, the fracture is accompanied by acute pain.

Damage can damage the false joint of the femoral neck and diaphragm. The process involves the proximal and distal metaepiphysis. Clinical manifestations are completely dependent on the form of the fracture. In many cases, the impossibility of moving the heel is fixed. There is a sharp pain in the hip joint. Any movement can cause unbearable pain.

Often the injury covers the epicondyle. The greater trochanter will determine the severity of the damage. In the presence of an offset, it is located much higher than its usual place. A severe fracture requires the introduction of special wires through the distal section. Possible complications, including necrosis. In this case, the formation that appeared during the injury is removed surgically.

With an isolated fracture, the gluteal muscle is involved in the process. In this case, detachment along the apophyseal line is fixed. The person feels limited pain during movement. With an isolated fracture, the gluteal muscle suffers due to short-term stress. The injury is often recorded in athletes overcoming obstacles.

Often there are lesions of the external department. This is due to active games or falling from a height. The level of damage depends entirely on its cause.

Fractures are:

diaphyseal;
low;
middle third.

Damage to the outer area is accompanied by acute pain and a long period of rehabilitation. The optimal treatment tactics is selected depending on the injury. The most severe damage is considered to be diaphyseal or high. Rehabilitation can take several months.

Os femoris is the longest and thickest of all the long bones of the human skeleton. It distinguishes the body and two epiphyses - proximal and distal.

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The body of the femur, corpus ossis femoris, is cylindrical in shape, somewhat twisted along the axis and curved anteriorly. The anterior surface of the body is smooth. On the back surface there is a rough line, linea aspera, which is the place of both the beginning and attachment of the muscles. It is divided into two parts: lateral and medial lips. The lateral lip, labium laterale, in the lower third of the bone deviates to the side, heading towards the lateral condyle, condylus lateralis, and in the upper third it passes into the gluteal tuberosity, tuberositas glutea, the upper part of which protrudes somewhat and is called the third trochanter, trochanter tertius.

femur video

The medial lip, labium mediale, in the lower third of the thigh deviates towards the medial condyle, condylus medialis, limiting here, together with the lateral triangular lip, the popliteal surface, facies poplitea. This surface is limited along the edges by vertically running unsharply pronounced medial supracondylar line, linea supracondylaris medialis, and lateral supracondylar line, linea supracondylaris lateralis. The latter, as it were, are a continuation of the distal sections of the medial and lateral lips and reach the corresponding epicondyles. In the upper section, the medial lip continues into the comb line, linea pectinea. Approximately in the middle part of the body of the femur, on the side of the rough line, there is a nutrient hole, foramen nutricium, - the entrance to the proximally directed nutrient channel, canalis nutricius.

The upper, proximal, epiphysis of the femur, epiphysis proximalis femoris, on the border with the body has two rough processes - the large and small skewers. Large spit, trochanter major, directed upwards and backwards; it occupies the lateral part of the proximal epiphysis of the bone. Its outer surface is well felt through the skin, and on the inner surface there is a trochanteric fossa, fossa trochanterica. On the anterior surface of the femur, from the top of the greater trochanter, the intertrochanteric line, linea intertrochanterica, passes down and medially, passing into the comb line. On the posterior surface of the proximal epiphysis of the femur, the intertrochanteric crest, crista intertrochanterica, runs in the same direction, which ends at the lesser trochanter, trochanter minor, located on the posteromedial surface of the upper end of the bone. The rest of the proximal epiphysis of the bone is directed upward and medially and is called the neck of the femur, collum ossis femoris, which ends in a spherical head, caput ossis femoris. The femoral neck is somewhat compressed in the frontal plane. With the long axis of the thigh, it forms an angle that in women approaches a straight line, and in men it is more obtuse. On the surface of the femoral head there is a small rough fossa of the femoral head, fovea capitis ossis femoris (trace of attachment of the ligament of the femoral head).

The lower, distal, epiphysis of the femur, epiphysis distalis femoris, is thickened and expanded in the transverse direction and ends with two condyles: medial, condylus medialis, and lateral, condylus lateralis. The medial femoral condyle is larger than the lateral one. On the outer surface of the lateral condyle and the inner surface of the medial condyle are the lateral and medial epicondyles, respectively, epicondylus lateralis et epicondylus mediate. Slightly above the medial epicondyle, there is a small adductor tubercle, tuberculum adductorium, - the site of attachment of the large adductor muscle. The surfaces of the condyles, facing one another, are delimited by the intercondylar fossa, fossa intercondylaris, which is separated from the popliteal surface at the top by the intercondylar line, linea intercondylaris. The surface of each condyle is smooth. The anterior surfaces of the condyles pass one into another, forming the patella surface, facies patellaris, the place of articulation of the patella with the femur.