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1830HildebrandtGF_WeberEH

 

The handbook records one of the early notions about the function of the ligamentum capitis femoris (LCF). This component is referred to as the "suspensory" ligament (Hångeband). The authors suggest that the LCF acts as a suspension for the thigh when the limb hangs freely without muscle tension. The ideas of E.H. Weber will be further developed by his brothers in the book "Mechanik dermenschlichen Gehwerkzeuge: eine anatomisch-physiologische Untersuchung" (1836). From our perspective, the LCF serves as a flexible suspension for the pelvis in the vertical position when supported on one leg.


Hildebrandt GF, Weber EH. Handbuch der anatomie des Menschen. Band 3. Schulbuchhandlung. Braunschweig: Verlag der Schulbuchhandlung, 1830. [fragment]

Quote pp. 292-293

Ligamentum teres (1). Um das Schenkelbein, wenn es herabhångt, noch fester zu halten, ist in der Höhle des Kapselbandes ein Hångeband angebracht, das man, weil es nach dem Schenkelkopfe zu rundlich wird, das runde Band nennt, das aber an der Pfanne dreieckig ist. Sein oberes Ende ist an dem innern Theile der Pfanne fest angeheftet, so, daß die innere obere Ecke desselben aus dem obern Winkel zwischen dem Rande der Pfanne und dem über den Ausschnitt hergespannten Querbande, die innere untere Ecke aus dem untern Winkel zwischen dem Rande der Pfanne und demselben Bande, die äußere Ecke aus dem untern innern Theile des Gewölbes der Pfanne an der Fett enthaltenden Masse der rauhen Grube entspringt. Von diesem obern Ende gegen den Schenkelkopf zu, wird es allmählig rundlicher und sein unteres Ende seht sich in der genannten Grube dieses Kopfs fest. Es dient die Bewegungen des Schenkelkopfs in der Pfanne in gewissen Richtungen einigermaßen einzuschränken und zu verhüten, daß er bei der Bewegung des Beins nicht zu weit aus der Pfanne herausweichen könne. Indessen ist es doch zu lang, um die Verrenkungen nach derjenigen Seite der Pfanne verhindern zu können, an welcher es angeheftet ist. In der That kann man, wenn man die Schenkelmuskeln durchschnitten hat, den Schenkelkopf, ohne das runde Band zu zerreissen, aus der Gelenkhöhle nach unten und innen herausziehen. Aber nach den übrigen Richtungen ist das nicht möglich. Paletta (2) hat Beobachtungen gesammelt, aus welchen hervorgeht, daß dieses Band auch bei Menschen fehlen könne, ohne daß sie eine Verrenkung des Knochens erleiden und ohne daß sie hinken. Das Labrum cartilaginum scheint noch nothwendiger zu sein, um den Schenkelkopf im Gelenke fest zu halten, als das runde Band.

An der Stelle, wo sich die Gelenkhaut zum runden Bande begiebt, um dasselbe zu überziehen, liegt unter der Gelenkhaut und in den Falten derselben eine beträchtliche Menge Gelenkfett.

Wenn das Bein in aufrechter Stellung fest steht und der Rumpf auf demselben ruht, so drückt sich der obere Theil der innern hohlen Fläche der Pfanne feft gegen die gewölbte Fläche des Schenkelkopfs, so, daß diese größtentheils von der Pfanne umschlossen wird. Auch ohne Feststellung des Beins können die Muskeln des Schenkels, wenn sie von allen Seiten sich aufwärts zusammenziehen, den Schenkelkopf in der Pfanne zurückhalten. In dieser Lage ist das Schenkelbein weniger beweglich. Wenn aber das Bein nicht fest sieht, sondern frei hångt, auch nicht von den Muskeln des Schenkels gegen die Pfanne gezogen wird, so kann, da die Långe des Kapselbandes und des Hångebandes es verstatten, sich die gewölbte Fläche des Schenkelkopfs von der innern hohlen Fläche der Pfanne etwas entfernen und wird, wenn das Schenkelbein herabhängt, durch die eigene Schwere desselben davon etwas abgezogen.

Die runde kuglige Beschaffenheit des Hüftgelenks, die Weite und Långe des Kapfelbandes und die Långe des Hångebandes verstatten dem Schenkelbeine eine hinlängliche Beweglichkeit. Man kann es vorwärts gegen den Bauch bewegen oder beugen, flectere, rückwårts bewegen oder ausstrecken, extendere, auswärts bewegen oder von dem andern abziehen, abducere, einwärts bewegen oder gegen das andere Bein anziehen, adducere, und durch die Verbindung dieser Bewegungen dasselbe trichterförmig bewegen, so, daß das untere Ende desselben einen Kreis beschreibt. Endlich aber kann der Schenkelknochen um eine Are gedreht werden, die seiner Långenare parallel ist. Durch Zusammensetzung dieser Bewegungen können noch viele andere Bewegungen auf die mannigfaltigste Weise geschehen, wie es die Bestimmung der Beine erfordert. Am stärksten kann die Beugung des Schenkels geschehen, so, daß die Knie ganz an den Bauch gezogen werden können, wie das z. B. schon bei der Frucht im Mutterleibe der Fall ist. Die dazu nöthige Drehung des Schenkelkopfs kann aber auch ohne eine Spannung des Hångebandes geschehen.

Es versteht sich von selbst, daß wenn der übrige Körper auf den Köpfen der Oberschenkelknochen ruht, und diese daher unbeweglicher find als er auch der Körper nach vorn, nach rechts und nach links gebogen oder auch nach hinten gezogen werden kann, und daß er sich auch um seine Långenare drehen kann. Unter diesen Umständen bewegen sich die Pfannen ebenso an den Köpfen der Oberschenkelknöchen wie im entgegengesezten Falle die Köpfe sich in den ruhenden Pfannen bewegen. Man kann auf diese Weise den auf den Schenkelköpfen ruhenden Körper fast um ebensoviel drehen als den Kopf auf den Halswirbeln. Für diesen Zweck der Drehung des übrigen Körpers` auf den Köpfen der Oberschenkelknochen ist es vortheilhaft, daß die Pfannen nicht so weit von einan der abstehen als die Gelenke der Oberarme, ferner daß der Hals der Oberschenkelknochen lang ist und nicht senkrecht, sondern schief steht, denn dadurch wird es möglich, daß zwischen dem Trochanter maior und dem Becken ziemlich lange Muskeln, welche eine sehr schiefe Lage haben und die also das Becken sammt dem übrigen Körper drehen können, Platz haben. 

1) Jean l'Admiral, ioon membranae vasculosae ad intima acetabuli ossium innominatorum positae. Amst. 1738. 8.

Thom. Schwenke, obs. anat. de acetabuli ligamento interno caput femoris firmante. Cum ejusd. haematologia. Hag. C. 1743. 8.

2) Paletta, Exercitationes pathologicae. Mediolani, 1820. p. 69; und in Meckels Archiv. B. VI. p. 343. Fälle, wo das runde Band fehlte, haben erzählt Sandifort, observationes anatomiae pathologicae. L. III. cap. 16. Salzman, in Halleri Diss. Vol. VII. Bonn, Thesaurus ossium morbosorum, p. 22. 43. 47. Caldani berichtete einen solchen auch Fall an Paletta.

Ligamentum teres (1). In order to hold the femur even more securely when it hangs down, a hanging [suspension] band is placed in the cavity of the capsule ligament, which is called the round ligament because it becomes too rounded around the femoral head, but it has a triangular shape in the socket. Its upper end is firmly attached to the inner part of the acetabular fossa so that its inner upper corner protrudes from the upper corner between the edge of the fossa and the transverse ligament stretched over the incision [acetabulum notch], the inner lower corner protrudes from the lower corner between the edge of the fossa and the same ligament, and the outer corner arises from the lower inner part of the vault of the fossa on the fat-containing mass of the rough pit. From this upper end towards the femoral head, it gradually becomes more rounded, and its lower end is fixed in the mentioned pit of head. It [ligamentum teres] serves to somewhat limit the movement of the femoral head in the acetabulum in certain directions and to prevent it from moving too far out of the socket when the leg moves. However, it is too long to prevent dislocations toward the side to which it is attached. In fact, it is possible to pull the femur out of the joint cavity downward and inward without tearing the round ligament if the muscles of the thigh are cut. But this is not possible in other directions. Paletta (2) has collected observations which indicate that this ligament may be absent in people without leading to bone dislocation or causing limping. The cartilaginous lip seems to be even more necessary to hold the femoral head in the joint than the round ligament.

Where the synovial membrane covers the round ligament, a significant amount of synovial fat is found beneath the synovial membrane and in its folds.

When the leg is in a vertical position and the torso rests on it, the upper part of the inner surface of the acetabulum closely presses against the convex surface of the femoral head, so that it is largely encompassed by the socket. Even without fixation of the leg, the muscles of the thigh, contracting from all sides upwards, can keep the femoral head in the acetabular socket. In this position, the femur is less mobile. However, if the leg is not fixed and simply hangs freely, and the thigh muscles do not pull it towards the acetabulum, the convex surface of the femoral head may slightly move away from the inner surface of the acetabulum, and when the femur hangs freely, it is slightly abducted from it under the influence of its own weight.

The round and spherical shape of the hip joint, the width and length of the capsule ligament, as well as the length of the suspensory ligament, provide sufficient mobility of the hip. It can be moved forward towards the abdomen or flexed, backward or extended, sideways or abducted, inward or adducted, and by combining these movements, it can be made conical so that its lower end describes a circle. Finally, the femur can be rotated around an axis parallel to its length. By combining these movements, many other movements can be performed in a variety of ways as required for leg function. The greatest degree of hip flexion is possible so that the knees can be pressed to the abdomen, as occurs, for example, with a fetus in the womb. However, for this rotation of the femoral head, it is also necessary to release tension from the suspensory ligament.

It goes without saying that if the rest of the body rests on the summits of the femurs, and they are therefore less mobile, then the body can also be bent forward, to the right, to the left, or backward, and it can also rotate around its long axis. Under these conditions, the acetabular fossae move around the femoral heads just as in the opposite case the heads move in the resting sockets. According to this principle, the body resting on the femoral heads can be rotated almost as much as the head can be turned on the cervical vertebrae. For this purpose of rotating the rest of the body on the summits of the femurs, it is useful for the acetabular fossae not to be as far apart as the shoulder joints, and for the neck of the femur to be long and inclined rather than vertical, as this allows for the placement of sufficiently long muscles between the greater trochanter and the pelvis, which can be in a very oblique position and thus rotate the pelvis along with the rest of the body. 

1) Jean l'Admiral, ioon membranae vasculosae ad intima acetabuli ossium innominatorum positae. Amst. 1738. 8.

Thom. Schwenke, obs. anat. de acetabuli ligamento interno caput femoris firmante. Cum ejusd. haematologia. Hag. C. 1743. 8.

2) Paletta, Exercitationes pathologicae. Mediolani, 1820. p. 69; und in Meckels Archiv. B. VI. p. 343. Cases where the round ligament was absent have been described by Sandifort [1779], observationes anatomiae pathologicae. L. III. cap. 16. Salzman [1725], in Halleri Diss. Vol. VII. Bonn, Thesaurus ossium morbosorum, p. 22. 43. 47. Caldani also reported one such case to Paletta. 




External links

Hildebrandt GF, Weber EH. Handbuch der anatomie des Menschen. Band 3. Schulbuchhandlung. Braunschweig: Verlag der Schulbuchhandlung, 1830. [archive.org , biodiversitylibrary.org , books.google]

Authors & Affiliations

Georg Friedrich Hildebrandt (1764-1816) was a pharmacist, chemist, and anatomist, professor of medicine, physics and chemistry in Erlangen, corresponding member of the Prussian Academy of Sciences. [wikipedia.org]

Georg Friedrich Hildebrandt.
Line engraving, unknown date, unknown author;
Original in the wikimedia.org collection (CC-BY-4.0, color correction)


Ernst Heinrich Weber (1795-1878) was an anatomist and physiologist, professor in Leipzige. [wikipedia.org]

Ernst Heinrich Weber (1856)
 Lithography by Rudolf Hoffmann, After a Photo by Schenk (Jena);
 Original in the wikimedia.org collection (CC0 – Public Domain, fragments)


Keywords

ligamentum capitis femoris, ligamentum teres, ligament of head of femur, anatomy, role, significance 

                                                                     .

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ROLE AND SIGNIFICANCE

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