1859PirogoffN

 

The author describes the study of the movement of the ligamentum capitis femoris (LCF) in frozen cadavers during hip movements. The researcher found that «…in the adducted hip, the upper Weber ligament and ligamentum teres are stretched». N. Pirogov provides an interesting analogy: «The Weber brothers compare this ligament [LCF] to a rope, correspondingly made of steel. Just as the wickerwork of our carts is suspended on round steel bases, so the pelvis, supported by ligamentum teres, rests on the thigh bones.». This may be a fragment from Weber W, Weber E. Mechanik der menschlichen Gehwerkzeuge (1836), although we were unable to locate this exact citation. According to 1874SavoryWS: «...Prof. Partridge in his lectures on anatomy at King's College was accustomed to compare the Ligamentum Teres, in its function, to the leathern straps by which the body of a carriage is suspended on springs».

Pirogoff N. Anatome topographica sectionibus per corpus humanum congelatum triplici directione ductus illustrate. Petropoli: Typis Jacobi Trey, 1859. [Lat.] (Pirogov N. An Illustrated Topographic Anatomy of Saw Cuts Made in Three Dimensions across the Frozen Human Body. St. Petersburg: Printed by James Trey, 1859.)	Пирогов НИ. Иллюстрированная топографическая анатомия распилов, произведенных в трех измерениях через замороженное человеческое тело: Альбом: в 4 ч., пер. с лат. ; гл. ред. Б.В. Петровский, Б.А. Константинов ; Доп. часть. Пояснительный текст к альбому. Москва: НЦХ РАМН, 1996; стр. 277. [Rus.]
Quote pp. 51-52	The translation from Russian was done in collaboration with ChatGPT 3.5.
2. Ligamentum teres, in spatio inter utramque (foveam acetabuli et capituli femoris) inclusum a margine posteriore incisurae acetabuli ischiopubicae (anterior inferior) paulo obliquâ vel potius verticali directione sursum, versus foveam capituli protenditur. Insertio hujus ligamenti in incisuram acetabuli, infundibuli instar excavate, inferius quam insertio in foveam capituli femoris sita est. In sectionibus articuli transversis hoc ligamentum directionem horizontalem, in sectionibus anteroposterioribus vero directionem obliquo-verticalem refert (Fasc. 4. Tab. 4 fig. 8. 9. 12. Fasc. 4. Tab. 5. fig. 2. Fasc. 4. B. Tab. 8. Fig. 3.). Quod ligamentum a fratribus Weber cum spira e chalybe facta apte comparator. Ut sirpeae nostrorum vehiculorum spiris chalybeis suspenduntur, ita pelvis ligamentis teretibus suspensa, femoribus nititur. Diversus femorum motus situm capituli et trochanteris majoris mutat vimque diversam in apparatum ligamentorum exercet. Experimentis a fratribus Weber, in cadaveribus institutis, doctum est, capitulum femoris flexi et extensi circuli arcum 139°, adducti et abducti arcum 90°, circum axem versi circuli arcum 50°, describere. Nostrae sections, per articulum ileofemoralem flexum, extensum abductum, adductumque institutae, demonstrant: 1. Totam anteriorem partem (sphaerae capitula) femoris usque ad initium foveolae (in quam ligam. teres inseritur), si articulus femoris fortissime extensi directione transversa persecetur, extra acetabulum prominere; partem posticam colli femoris margine posteriori acetabuli niti; trochanterem majorem ad tuber ischii adpropinquari; parietem anteriorem quidem membranae capsularis valde, sed ligamentum teres paulo tendi, et parietem posteriorem relaxari et plicari (Fase. 4. Tab. 5. fig. 2.). In femore ad ventrem valde flexo et transversa directione persecto discos sectionis eundem, quem in femore recto, habere aspectum, si modo situm trochanteris majoris (D), cujus fossa in anteriorem partem dirigitur, excipias (Fase. 4. Tab. 5. fig. 1.). (In femore ultra modum extenso, quod indagationes fratrum Weber demonstrant, zona orbicularis (vid. Supra) nimis tensa membranam capsularem articuli, torquet capitulum femoris ad acetabulum fortissime adprimit eoque impedit quominus femur in anteriorem partem luxetur). …  4. In sectionibus, articulum femoris abducti et adducti in duos discos anteriorem et posteriorem findentibus, nunquam tanta sphaerae (capitula) pars, quanta in femore flexo et extenso, e finibus acetabuli excedere videtur (Fasc. 4. B. Tab. 8). Quae res vel situ vel directione acetabuli explicari potest. Nam supra jam vidimus, acetabulum ita esse dispositum, marginemque ipsius superiorem et externum ita prominere, ut major capituli pars sub hoc fornice condatur; sectiones vero, quibus situs capituli in femore flexo vel extenso demonstrator, per partes acetabuli minus prominentes ducendae sunt. In femore abducto paries inferior membranae capsulares praecipue tenditur, e ligamentum teres relaxatur; in adducto ligamentum superius Weberi et ligamentum teres tenduntur (Fasc. 4. B. Tab. 8).	Ligamentum teres, located in the space between both fossae (the fossa of the acetabulum and the head of the femur), extends from the posterior edge of the ischiopubic (anterior inferior) notch to the fossa of the head in a slightly inclined or, rather, vertical direction. The attachment of this ligament to the notch of the acetabulum is concave in the form of a funnel and is located lower than its attachment to the fossa of the femoral head. In cross sections of the joint, this ligament is located horizontally, and in longitudinal sections on the front and rear discs - obliquely vertical (Vol. 4, Tab. 4, Fig. 8, 9, 12. Vol. 4, Tab. 5, Fig. 2. Vol. 4B. Tab. 8. Fig. 3.). The Weber brothers compare this ligament to a rope, correspondingly made of steel. Just as the wickerwork of our carts is suspended on round steel bases, so the pelvis, supported by ligamentum teres, rests on the thigh bones. Different movements of the hips affect the position of the femoral head and greater trochanter differently and have varying effects on the ligamentous apparatus. Through experiments on cadavers by the Weber brothers, it has been established that the femoral head of a flexed and extended hip describes an arc of 139°; the femoral head of an adducted and abducted hip describes an arc of 90°, while the femoral head rotating around its axis describes an arc of 50°. Our dissections, conducted through the hip joint in flexed, extended, adducted, and abducted states, reveal the following: 1. The entire anterior part of the sphere (femoral head) up to the beginning of the fossa (to which the ligamentum teres is attached) protrudes beyond the acetabulum if the joint of a strongly extended femur is sawed in the transverse direction; the back of the femoral neck rests on the posterior edge of the acetabulum; the greater trochanter approaches the tuberosity of the ischium; the anterior part of the capsular membrane is stretched strongly, and the ligamentum teres - weakly; the back wall relaxes and becomes covered with folds (Vol. 4. Tab. 5. Fig. 2). You find that in the thigh, strongly bent towards the abdomen and sawn in a transverse direction, the discs have the same appearance as in the straight thigh, excepting only the position of the greater trochanter (D), the fossa of which is directed forward (Vol. 4, Table 5, Fig. 1). (As the Weber brothers showed, in a hip that is strongly extended forward, an excessively tense circular zone (see above) twists the capsular membrane of the joint, strongly presses the femoral head against the acetabulum and thereby prevents dislocation of the joint). ...  4. In the dissections that divide the adducted and abducted hip joint into two - anterior and posterior - discs, it seems that the part of the femoral sphere (head) that extends from the boundaries of the acetabulum never leaves them, as it does in the flexed and extended hip (Vol. 4B, Table 8). This can be explained by the position or orientation of the acetabulum. As we have already seen, the acetabulum is positioned in such a way, and its upper outer edge protrudes forward in a manner that most of the head is concealed beneath the vault; however, the dissections that demonstrate the position of the head in the flexed or extended hip must be made through less prominent parts of the acetabulum. In the abducted hip, the lower wall of the capsular membrane is particularly stretched, while the ligamentum teres relaxes; in the adducted hip, the upper Weber ligament and ligamentum teres are stretched (Vol. 4B, Table 8).

  

Vol. 4B, Table 8. (Pirogoff N. Anatome topographica sectionibus per 

corpus humanum congelatum triplici directione ductis illustrate; 

Pars IV, fasc. 4.-4 A.-4 B. Cavum abdominis et pelvis. 

Petropoli: Typis Jacobi Trey, 1853. archive.org)

External links

Pirogoff N. Anatome topographica sectionibus per corpus humanum congelatum triplici directione ductus illustrate. Petropoli: Typis Jacobi Trey, 1859.  [books.google , archive.org] 

Authors & Affiliations

Nikolay Ivanovich Pirogov (1810-1881) was a Russian scientist, medical doctor, pedagogue, professor of surgery at the Imperial Academy of Military Medicine in Saint Petersburg.  [wikipedia.org]  

 

Portrait of Nikolay Pirogov by Ilya Repin (1881);
the State Tretyakov Gallery, Moscow, Russia (fragment) 

Keywords

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

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