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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NEWS

New publications of our resource ( section started June 04, 2024 ) January 11, 2025 Acetabular Canal. Part 1. This article describes the space where the ligamentum capitis femoris (LCF) attaches and functions. See also Part 2 and Part 3 . January 10, 2025 1877MorrisH An excerpt from an article noting that the LCF is stretched during flexion, adduction, external rotation, and is always torn during hip dislocations. January 8, 2025 1877BrookeC Report and discussion on Henry Morris's paper Dislocations of the Thigh: their mode of occurrence as indicated by experiments, and the Anatomy of the Hip-joint, with mentioning the role played by LCF. January 7, 2025 Tweet of January 7, 2025 1898AshhurstJ The author discusses the function of the LCF as a supporting element of the body, its role in the development of deformity of the hip joint, reducing pressure and stress in the femoral head. January 4, 2025 2024Migliorin...

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1857RichetA

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1753TarinP

Fragments from the book Tarin P. Ostéo-graphie (1753). The author notes the localization of ligamentum capitis femoris (LCF) and uses synonyms: ligament rond, ligamentum teres capitis femoris. The text is prepared for machine translation using a service built into the blog from Google or your web browser. Quote p. 24 Les Ligamens de l'extrémité inférieure sont, 1°. la Membrane capsulaire, &c. de la cavité cotyloïde, le Ligament rond, l'Appareil ligamenteux propre à cette cavité; le Ligament transveríal interne de son bord, le transversal externe, les deux Ligamens glanduleux; … Quote p. 54. Illæ tres offeæ portiones simul unitæ Cavitatem cotyloïdeam q.t. a. constituunt, in qua occurrit Foveols h. glandulas synoviales articulationis excipiens, cuique sesc inserit ligamentum teres capitis femoris, &c. Vid. t. u. v. TAB. I. II. III. External links Tarin P. Ostéo-graphie, ou Description des os de l'adulte, du foetus, &c. Precedée d'une introduction a l'etu...

1877BrookeC

Report by Brooke C. and discussion of the article Dislocations of the Thigh: their mode of occurrence as indicated by experiments, and the Anatomy of the Hip-joint. By Henry Morris. M.A., M.B. (1877). In the discussion, Dr. Barwell remarked that: «He agreed with Mr. Morris in regarding the ligamentum teres as of little importance in the prevention of dislocation; it probably did little more than protect the vessels passing to the head of the bone. He saw a case some years ago, in which there was congenital absence of the ligamentum teres; but he had no reason for believing that the man was more liable to dislocation of the femur than other persons.» The author of the article, Henry Morris, suggested that Malgaigne «... did not attach much importance to the ligamentum teres; and believed that it had no power to hold the bone in its place.». ROYAL MEDICAL AND CHIRURGICAL SOCIETY. TUESDAY, FEBRUARY I3TH, 1877. CHARLES BROOKE, F.R.C.S., F.R.S., Vice-President, in the Chair. D...

398-405Jerome of Stridon

Fragments of the Book of Genesis translated by Jerome of Stridon (398-405). The Latin text contains mentioned to ligamentum capitis femoris (LCF) of an animal and a human. See our commentary at the link: 398-405Jerome of Stridon [Rus]. Quote [Lat] Genesis 32:25,32 25. Qui cùm videret quòd eum sperare non posset, tetigit neruum femoris eius, & statim emarcuit. (original source: 1572 MontanoBA , p. 110) 32. Quá ob causam non comedunt neruú filij Israel, qui emarcuit in femore Iacob, vsq; in præsentem diem, eo quòd tetigerit neruú femoris eius, & obstupuerit. (original source: 1572 MontanoBA , p. 112) Translation [Eng] Genesis 32:25,32 25. But when he saw that he could not prevail against him, he touched the sinew of his thigh, and immediately it withered. (original source: 1572 MontanoBA , p. 110; our translation) 32. For this reason, the children of Israel do not eat the sinew that withered in Jacob's thigh to this day, because he touched the sinew of his thigh and dam...

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