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1863HenkeW

 

In selected excerpts, the author describes the anatomy and topography of the LCF. Wilhelm von Henke observed tension in the LCF during hip supination. It is also noted that the strength of the LCF can vary and sometimes be quite significant. Additionally, the author highlights the involvement of hip joint ligaments in maintaining a «relaxed» posture.

The translation from German was done in collaboration with ChatGPT 3.5. 

Henke W. Handbuch der Anatomie und Mechanik der Gelenke: mit Rücksicht auf Luxationen und Contracturen. Leipzig, Heidelberg: C.F. Winter, 1863. [fragments]

Quote p. 202

Auch dieser Rand von überknorpelter knöcherner Pfanne hat eine grosse Lücke in seinem unteren Theile. Hier spannt sich ein Theil des Labrum als Lig. transversum acetabuli herüber und unter dieser Brücke durch öffnet sich die Lücke zwischen dem Gelenkkopfe und dem mittleren Theil der Pfanne, welcher ihm nicht genau anschliesst. Dieselbe ist erfüllt von einem lockeren fetthaltigen Polster an der Pfanne aufsitzender Synovialbekleidung und enthält ausserdem des Lig. teres, das über dem Loch zwischen Lig. transversum und Pfanne an diesen beiden breit, und an einer kleinen Lücke des Knorpelüberzugs in der Mitte des Gelenkkopfes zusammengedrängt ansitzt, sodass es, jenachdem diese Stelle ihre Lage über der mittleren Vertiefung der Pfanne wechselt, sich in verschiedenen Richtungen in das Fettpolster des letzteren eindrückt. Durch seinen Ursprung über dem Eingang in die Lücke des Contactes der Gelenkflächen und seine festere Zusammenschliessung gegen die Befestigung am Gelenkkopfe hin, verwahrt es die erstere schon ziemlich vollständig.

Also, this edge of the cartilage-covered bony socket has a large gap in its lower part. Here, a portion of the acetabular labrum extends across it in a transverse direction as the transverse ligament of the acetabulum, and under this bridge, a gap opens between the joint head and the middle part of the socket, which does not fully adhere to it. It is filled with soft fatty pad material lying in the socket, covered with a synovial inner layer, as well as lig. teres, which is located between the transverse ligament and the socket, and also in a small gap in the cartilaginous covering in the middle of the articular head, so that, depending on how this place moves over the middle part of the socket, it is pressed in different directions into the fat pad. When the articular surfaces come into contact, due to its origin above the entrance to the gap and a stronger connection with the articular head, it reliably protects the latter.

 

Quote p. 205

Etwa im Scheitel des Gelenkkopfes ist der Knorpelüberzug desselben durch die Lücke unterbrochen, in welcher sich der glatte gefässhaltige Strang des Lig. teres inserirt, welcher sonst frei und glatt zwischen ihm und der Pfanne liegt (S. o. S. 202. Fig. 46).

Approximately at the apex of the joint head, the cartilage covering of the joint head is interrupted by the gap in which the smooth vascular strand of the ligament teres is inserted, which otherwise lies free and smooth between it and the socket (see above p. 202. Fig. 46).

 


Quote p. 206

Ausserdem muss auch die Stelle des Gelenkkopfes, an welcher das Lig. teres angeheftet ist, immer über der Lücke des Pfannengrundes bleiben, da sich sonst das Band zwischen die Gelenkflächen einklemmen müsste, während es sich in den lockeren Synovialfalten, welche die Lücke erfüllen, bei allen Lagen seiner Insertion über denselben hin und her eindrücken kann. Es kommt aber fast nie zu wirklicher Spannung.

In addition, the place on the articular head where the lig. teres, must always be above the gap above the bottom of the socket, since otherwise the ligament could be pinched between the articular surfaces, while in the free synovial folds that fill this cavity, it can freely move back and forth in any position of its attachment point. However, there is almost never any real tension.

Quote p. 208

Das Lig. teres verhält sich zur Beugung und Streckung vollkommen indifferent, da die Achse derselben seinen Verlauf in der Pfannenlücke, von beiden Anheftungsstellen nicht weit entfernt schneidet.

The lig. teres is completely indifferent to flexion and extension, as its axis intersects the cavity of the acetabulum not far from both points of attachment. 

Quote p. 210

Das Lig. teres kann gespannt werden, wenn sein Ansatz am Gelenkkopfe stark nach oben bewegt, also wenn dieser um eine von hinten nach vorn verlaufende Achse mit medialen Punkten nach oben gedreht wird. Dies ist der Fall bei Adduction in gestreckter, und bei Rotation nach der Seite in gebeugter Lage. Erstere wird bereits anderweitig gehemmt, ehe es zur Spannung des Lig. teres kommt. Für letztere kann dieselbe abschliessend wirken. Wenn man z. B. den einen Fuss auf das andere Knie legt, so kann der erhobene Oberschenkel nicht herabsinken und zwar nur deshalb, weil er dann zugleich, wenn der Fuss oben bleiben soll, noch weiter um seinen Längsdurchmesser gedreht werden müsste; dies hindert das Lig. teres, denn übrigens schwebt das erhobene Knie frei in der Luft. Es federt aber zurück, wenn man es niederdrückt.

The lig. teres can be stretched when its origin on the joint head is significantly raised upwards, that is, when it rotates upwards and towards the midline around an axis oriented from back to front. This occurs during adduction in the extended position and external rotation in the flexed position. The former is inhibited by other means before tension on the lig. teres occurs. For the latter, it can be an isolated effect. For instance, if one leg is placed on the other knee, the raised thigh bone will not lower down only because it would need to be further rotated around its longitudinal axis if the leg is to stay up; this is prevented by the lig. teres, as the raised knee hangs freely in the air. However, it springs back when pressed down upon.

Quote p. 211

Dass das Lig. teres bei Adduction nicht zur Spannung kommt, weil dieselbe anderweitig gehemmt wird, ehe es geschehen würde, hat Henle durch eine Oeffnung der Pfanne von der Beckenseite her beobachtet. Ich habe denselben Weg eingeschlagen und die Spannung des Bandes bei der obenerwähnten Rotation gefunden, die er vielleicht übersehen hatte. Vielleicht ist es auch bei einzelnen Individuen verschieden. Wenigstens habe ich auch in manchen Fällen, wie Henle gesehen, dass das Band nur aus lockerem gefässreichen Gewebe besteht, während es in anderen ganz feste Fasern hat.

The fact that the lig. teres does not stretch during adduction due to another inhibitory mechanism, which is implemented before it occurs, which Henle observed through a hole in the acetabulum made from the side of the pelvis. I followed the same path and found tension on the ligament during the aforementioned rotation [supination], which he may have overlooked. Perhaps this also varies among individual subjects. At least, like Henle, I have seen that this ligament consists only of loose vascular tissue in some cases, while in others it has very strong fibers.

Quote p. 216

Wenn aber der Körper wesentlich nur auf dem einen Beine ruht, das andere nur leicht aufgesetzt ist, wie dies ganz gewöhnlich beim Stehen geschieht, so können auch die Drehungen der unterstützenden Hüfte um die anderen Achsen verschiedene sein und die Bedingungen ihrer Ruhelage aufgesucht werden.

Die Drehung um die sagittale Achse steht dann, wie die um die quere unter dem Einflusse der Schwere des Rumpfes, da der Drehpunkt der tragenden Hüfte zur Seite von dem Perpendikel des Schwerpunktes liegt. Sie begünstigt eine Annäherung der Medianebene des Beckens an den tragenden Oberschenkel, oder, was dasselbe ist, Adduction des letzteren. Eine solche ist denn auch vorhanden, indem das Becken von der tragenden Hüfte etwas herabhängt, während das Bein zu derselben hin etwas seitwärts nach oben hingerichtet, sowie auch die Wirbelsäule etwas nach dieser Seite hin gebogen ist. Wird nun diese Adduction so gesteigert, dass sie mehr oder weniger schon an der Spannung der Bänder ihre Hemmung findet, so zeigt sich eine schlaffe Haltung in der Ansicht von vorn mit stark heraustretender Hüfte der tragenden Seite, wie die mit schwacher Neigung im Profil. Wird aber durch Spannung der Mm. glutaei das Extrem derselben vermieden, so wird die ganze Haltung gerader und strammer. 

But if the body rests essentially on only one leg, and the other is only slightly adducted, as is often the case when standing, then rotations of the supporting hip around other axes can also be different, and the conditions of their rest can be identified.

Rotation around the sagittal axis, as well as around the transverse axis, occurs under the influence of the weight of the torso, since the pivot point of the supporting hip lies off the perpendicular from the center of gravity. This promotes the approximation of the median plane of the pelvis to the supporting thigh or, equivalently, adduction of the latter. The same adduction is present when the pelvis slightly hangs down from the supporting hip, with the leg directed sideways and upwards, and the spine tilts slightly in that direction. If this adduction is increased to the point where it is limited by tension in the ligaments, then for an observer from the front, a relaxed posture with a prominently protruding hip on the supporting side appears, as well as with a slight inclination in profile. However, if this extreme is avoided by tension in the gluteal muscles, the entire posture becomes more straightened and tense.

External links

Henke W. Handbuch der Anatomie und Mechanik der Gelenke: mit Rücksicht auf Luxationen und Contracturen. Leipzig, Heidelberg: C.F. Winter, 1863. [books.google] 

Authors & Affiliations

Philipp Jakob Wilhelm von Henke (1834-1896) was a German anatomist, professor, and head of the department of anatomy in Rostock, Prague and in Tübingen. [deutsche-biographie.de] 

Portrait of Philipp Jakob Wilhelm von Henke (1902)
Unknown author; original in the 
wikimedia.org collection (CC0 – Public Domain, no changes)


Keywords

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

                                                                     

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