The os innominatum

Ligamentum Teres
Fig. 158 The anterior aspect of the right femur.

and forwards. It is covered with cartilage except for its central fovea where the ligamentum teres is attached.

The neck is 2 in (5 cm) long and is set at an angle of 125° to the shaft. In the female, with her wider pelvis, the angle is smaller.

The junction between the neck and the shaft is marked anteriorly by the trochanteric line, laterally by the greater trochanter, medially and somewhat posteriorly by the lesser trochanter and posteriorly by the prominent trochanteric crest, which unites the two trochanters.

The blood supply to the femoral head is derived from vessels travelling up from the diaphysis along the cancellous bone, from vessels in the hip capsule, where this is reflected on to the neck in longitudinal bands or retinacula, and from the artery in the ligamentum teres; this third source is negligible in adults, but essential in children, when the femoral head is separated from the neck by the cartilage of the epiphyseal line (Fig. 160).

The femoral shaft is roughly circular in section at its middle but is flattened posteriorly at each extremity. Posteriorly also it is marked by a

Iliac crest Posterior superior spine

Greater sciatic notch

Ischial spine Lesser sciatic notch

Ischial tuberosity

Lesser trochanter Spiral line

Adductor tubercle Intercondylar fossa

Iliac crest Posterior superior spine

Greater sciatic notch

Ischial spine Lesser sciatic notch

Ischial tuberosity

Lesser trochanter Spiral line

Adductor tubercle Intercondylar fossa

Sciatic Notch

Greater trochanter Intertrochanteric crest

Gluteal tuberosity

Linear aspera

Lateral epicondyle

Greater trochanter Intertrochanteric crest

Gluteal tuberosity

Linear aspera

Lateral epicondyle

Fig. 159 The posterior aspect of the right femur.

Intertrochanteric Crest Post
Fig. 160 The sources of blood supply of the femoral head—along the ligamentum teres, through the diaphysis and via the retinacula.

strong crest, the linea aspera. Interiorly, this crest splits into the medial and lateral supracondylar lines, leaving a flat popliteal surface between them. The medial supracondylar line ends distally in the adductor tubercle.

The lower end of the femur bears the prominent condyles which are separated by a deep intercondylar notch posteriorly but which blend anteri-

Subcapital

Subcapital Neck Femur Picture

Pertrochanteric

.Cervical .Basal

Fig. 161 The head and neck of the femur, showing the terminology of the common fracture sites.

orly to form an articular surface for the patella. The lateral condyle is the more prominent of the two and acts as a buttress to assist in preventing lateral displacement of the patella.

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