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The First Conservative Treatment

 

Conservative treatment of ligamentum capitis femoris (LCF) pathology is, without exaggeration, a highly complex subject. We understand how to repair LCF surgically, although we have not yet achieved significant success in this (2024). Methods of drug therapy for changes in LCF are not even discussed today.

The first attempt at treating post-traumatic changes in LCF with recurrent hip dislocations was made by Galen of Pergamon (129-210/217 AD) over 19 centuries ago. In Hippocratis de articulis liber et Galeni in eum commentarius quatus (IV, 40), he wrote: «And when mucus builds up in the joint, then the ligament [LCF] softens and weakens as a result. And it does not matter whether you call it a ligament (σύνδεσμον) or a connecting sinew (νεῦρον συνδετικόν). For those ligaments that have a rounded shape like tendons are usually called connecting sinews by anatomists. And we have already cured this kind of hip dislocation twice, and it did not dislocate again. Drying medications should be applied over the joint for a long time until the connective sinew is dry enough to stop stretching together with the femur extending beyond the edge of the acetabulum and keep it in its natural position» (1829KühnCG; 2020ArkhipovSV_ProlyginaIV).

According to the author, the method turned out to be successful. At the same time, a positive effect could probably be achieved only through prolonged immobilization without medicinal applications.

Keywords

ligamentum capitis femoris, ligamentum teres, ligament of head of femur, conservative treatment, Galen, hip joint, dislocation

REFERENCES

Kühn CG. Clavdii Galeni Opera omnia. Editionem cvravit D. Carolvs Gottlob Kühn, professor physiologiae et pathologiae in literarvm vniversitate Lipsiensi pvblicvs ordinarivs etc. Tom. XVIII. Pars I. Lipsiae: prostat in officina libraria Car. Cnoblochii, 1829. [archive.org]

Arkhipov SV, Prolygina IV. Ancient Textual Sources on Ligamentum Teres: Context and Transmission. MLTJ. 2020;10(3):536-546. [mltj.online,  mltj.online(PDF), researchgate.net]

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In translating to English, the author is assisted by ChatGPT (version 3.5) and the Google Translate service.

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CONSERVATIVE TREATMENT

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