Structure and functions of the human femur: linea aspera, distal end, adductor tubercle

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Osteology and arthrology

This article will discuss the structure of the femur. This is a fairly large bone, tubular in shape, long, and has thickened proximal and distal ends.

Anatomy of the femur

The femur plays an important role in the human body, as 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.

Skeleton of the free part of the lower limb

The skeleton of the free part of the lower limb (pars libera membrae inferioris) consists of the femur, patella, leg bones and foot bones.

The femur (os femoris) (Fig. 55, 56), as well as the humerus, ulna and radius, is a long tubular bone, the proximal epiphysis of which ends in the head, and the extended distal one has two condyles (medial and lateral). The diaphysis of the femur is slightly curved forward; its anterior surface is smooth, and along the posterior surface there is a longitudinal rough line (linea aspera) (Fig. 46), in which the medial (labium mediale) and lateral (labium laterale) lips are distinguished (Fig. 46). Slightly below the upper epiphysis there is a protrusion called the gluteal tuberosity (tuberositas glutea) (Fig. 46).

The head (caput ossis femoris) (Fig. 46) of the proximal epiphysis of the femur is connected to the diaphysis by the long neck of the femur (collum ossis femoris) (Fig. 46), somewhat compressed in the anteroposterior direction and forming an obtuse angle with the body of the bone (in men this angle noticeably more than in women). In the center of the femoral head there is a fossa of the femoral head (fovea capitis ossis femoris) (Fig. 46). The bone protrusions located above and below at the junction of the bone body with the neck - the greater (trochanter major) (Fig. 46) and the lesser trochanters (trochanter minor) (Fig. 46) - are connected to each other by the intertrochanteric ridge (crista intertrochanterica) ( Fig. 46) and the intertrochanteric line (linea intertrochanterica) (Fig. 46). The depression located at the base of the greater trochanter is called the trochanteric fossa (fossa trochanterica) (Fig. 46).

The medial (condylus medialis) and lateral (condylus lateralis) condyles (Fig. 46), located on the lower epiphysis of the femur, are separated posteriorly by the intercondylar fossa (fossa intercondylaris) (Fig. 46). In front, the condyles close, forming a platform for connection with the patella. The posterior and inferior surfaces of the condyles, covered with cartilage, are involved in the formation of the knee joint; each condyle corresponds to an epicondyle located above it (epicondylus) (Fig. 46).

The patella, or patella (Fig. 54, 55, 56), protecting the knee joint in front, is attached to the tendon of the quadriceps femoris muscle. The patella is a sesamoid bone in the shape of a triangle, with its apex pointing downwards, with a rough anterior surface. The smooth posterior surface is covered with articular cartilage.

The tibia of the leg (tibia) (Fig. 55, 56) is a long tubular bone with a massive (compared to the fibula) triangular diaphysis, which turns into a tetrahedron closer to the distal epiphysis. The wide upper epiphysis of the bone ends with the medial (condylus medialis) and lateral (condylus lateralis) condyles (Fig. 49), the flat upper articular surface (facies articularis superior) (Fig. 47, 49) of which, covered with articular cartilage, is slightly concave and has a in the center is the intercondylar eminence (eminentia intercondylaris) (Fig. 47, 49). The lateral condyle has another articular surface, the fibular surface, located on its lateral surface and participating in the formation of the tibiofibular joint with the proximal epiphysis of the fibula.

The medial, lateral and posterior surfaces (Fig. 47, 49) of the body of the tibia are separated by sharp edges - anterior (margo anterior) (Fig. 47, 49), interosseous (margo interosseus) (Fig. 47, 49) and medial (margo medialis) ) edges. The anterior edge at the top passes into the tuberosity of the tibia (tuberositas tibiae) (Fig. 47, 49, 54).

The distal epiphysis of the tibia has a fibular notch on the lateral side, and on the medial side there is a downward-directed medial malleolus (malleolus medialis) (Fig. 47, 49), covered, like the upper articular surface, with articular cartilage.

The fibula of the leg (fibula) is located lateral to the tibia. The articular surface of the upper epiphysis - the head of the fibula (caput fibulae) (Fig. 48, 54) - serves for articulation with the lateral condyle of the tibia. The thickened distal epiphysis ends in the lateral malleolus (malleolus lateralis) (Fig. 48, 49). The space between the diaphyses of the tibia and fibula is covered, as in the forearm, by a strong fibrous membrane - the interosseous membrane of the tibia, which is attached to the interosseous edges of the bones of the leg.

The tarsal bones (ossa tarsi) are short and spongy. The foot is connected to the bones of the lower leg by the talus (Fig. 50, 51). The head of the talus (caput tali) (Fig. 50, 51) connects to the scaphoid bone (os naviculare). The body of the talus (corpus tali) ends at the top with the block of the talus (trochlea tali) (Fig. 50, 51), which participates in the formation of the ankle joint. The upper and lateral surfaces of the block are covered with articular cartilage. The lower surface of the body of the talus has articular surfaces through which it articulates with the calcaneus (Fig. 50, 51). The latter has corresponding articular surfaces on the upper surface. The anterior surface of the calcaneus, extended relative to the foot in the anteroposterior direction, also has articular surfaces that serve for articulation with the cuboid bone. On the medial surface of the body of the calcaneus there is a process that supports the talus. The calcaneus ends at the back with the tuber of the calcaneus (tuber calcaneus) (Fig. 50, 51).

Together, the talus and calcaneus make up the proximal row of tarsal bones. The distal row is represented by the scaphoid (os naviculare), cuboid (os cuboideum) and three wedge-shaped (ossa cuneiformia) bones (Fig. 50, 51).

The metatarsal bones (metatarsus) (Fig. 50, 51), like the metacarpal bones of the palm, are elongated and have a base, body and head. The bases of the metatarsal bones are connected to the cuboid (IV and V) and three wedge-shaped bones of the tarsus, while the base of the II metatarsal bone enters the space between the medial and lateral wedge-shaped bones protruding forward. The heads of the metatarsal bones articulate with the bases of the proximal phalanges. There are five metatarsal bones in total; the first (I) is noticeably more massive.

The bones of the toes (ossa digitorum pedis) (Fig. 50, 51), or phalanges of the toes, also have a body, a base and a head. All fingers, except the first (I), have three phalanges (proximal, middle and distal). The first finger has only two phalanges.

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:

1. 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.
2. 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, in simple fractures the fragments come 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 of damage to the femur occurs 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 at the knee joint, but 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.

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 impairs 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;
• A bone cyst is a benign tumor-like formation.

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.

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:

1. Joint injury.
2. Failures in metabolic processes.
3. Congenital dysplasia of the joints, which affects not only the articular surfaces, but also the entire ligamentous apparatus.
4. Disturbances in the functioning of the endocrine system.
5. Aging of the body, during which the structure of bones and ligaments changes.
6. Systematic loads associated with monotony of work.
7. Spread of infection into surrounding tissues.
8. Inflammatory processes in the joints.

Clinical picture:

1. Pain on palpation and movement of the limb.
2. As you move, the bones begin to crunch.
3. The skin at the site of the lesion changes color and becomes red.
4. Local increase in temperature at the site of injury.
5. The joint cannot perform its direct functions.

Features of structure and structure

Tubular matter is attached to other parts of the skeleton through joints and ligaments. Muscles are adjacent to the connective tissues, and nerves and blood vessels are located parallel to the bone. The area at the junction of the tendons and the hard body has a bumpy 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 is located inside, on the back of the bone, and the second is palpable 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. A line as rough runs along the back of 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 with bone marrow is laid through the diaphysis, where blood cells are formed. Subsequently, mature red blood cells are replaced by adipose tissue.

Distal epiphysis

The lower part of the bone 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, soft tissues and blood vessels are attached to the surface.

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. At a later stage, the inflammatory process caused by bursitis begins to spread to the lower part of the thigh, thereby causing lameness in the patient. Even if this does not reduce the load on the affected limb, then after a while pain may begin to appear at rest.

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 performed if, when the leg is abducted, it is not possible to set the bone fragments.

Tendinosis therapy

Treatment of this pathology is carried out using complex 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.

Using elastic bandages or bandages, the affected joint is limited in movement. In addition, physiotherapeutic procedures are used to treat tendinosis. Magnetic therapy, laser therapy, ultrasound, for example, have a good effect; applications of therapeutic mud and baths with mineral salts also help. 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 a last resort treatment for this disease and is used in very rare cases. Doctors try to manage with conservative methods of therapy.

What to do with bursitis?

Treatment of bursitis should begin with simple procedures. Very rarely, this disease requires surgical intervention. Patients under thirty years of age are recommended to reduce the load on the affected joint and undergo a course of rehabilitation therapy, which includes exercises to stretch the muscles of the thighs and buttocks.

Treatment of inflammation of the greater trochanter of the femur involves the use of anti-inflammatory drugs. 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 used immediately after an injury, and heat is used for inflammatory processes that occur in a chronic form. An experienced physiotherapist will be able to give useful recommendations, using which you can completely restore all motor functions of the 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. The hormonal drug quickly relieves inflammation. The effect of the procedure can last for 6-8 months.

A timely visit to a doctor will help to cure all existing disorders in the femur in a short time. If any of the pathologies in a given part of the human body becomes chronic, then the pain syndrome stops only for a while.

What is the hip and what functions does it perform?

The thigh is the upper part of the lower limb, the area between the pelvis and the knee. It is a kind of connecting link between the lower limbs and the torso.

Reference . “Femur” is the name of the thigh in Latin.

The large femoral region of the leg is responsible for the following functions :

• flexion-extension of the leg,
• limb rotation,
• abduction-adduction,
• moving, turning, braking,
• participation in the process of hematopoiesis (blood cells form, develop and mature in the bone marrow: leukocytes, erythrocytes, platelets).

This part of the leg serves as a support for the body , providing stability to the human body.