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1844PetitJL

 

Fragments from the book Petit JL. Maladies des os, maladies chirurgicales (1844). Reprint of an 18th-century author's work discussing the anatomy, role, and damage of the ligamentum capitis femoris (LCF) in hip dislocation. The text is prepared for machine translation using a service built into the blog from Google or your web browser. 

Quote p. 80

DE LA LUXATION DE LA CUISSE.

La tête du fémur est très-grosse, et la cavité de l'ischion fort profonde. Elles sont l'une et l'autre revêtues d'un cartilage poli, excepté cependant aux endroits où il n'y a point de frottement, c'est-à-dire aux attaches d'un ligament qui se trouve dans l'intérieur de l'article, et qui s'insère à la tête du fémur, un peu au-dessous du milieu, et prend origine de la partie excentrale et inférieure de la cavité cotyloïde , où se trouve un enfoncement pour loger les glandes synoviales.

…

La cavité cotyloïde est plus profonde en haut et en arrière qu'en bas et en devant. Elle a, par sa partie inférieure, une échancrure fermée par un ligament sous lequel passent les vaisseaux qui portent la nourriture au ligament intérieur connu sous le nom de ligament rond, aux glandes synoviales et aux autres parties de l'article. 

Quote p. 81

4. Le ligament rond s'oppose à l'éloignement de l'os, non à la vérité dans tous les sens, parce qu'il n'est pas attaché précisément dans le plus profond de la cavité ni au milieu de la tête, mais du moins, comme on va le faire observer, résiste-t-il à plusieurs espèces de luxations.

…

Des différentes Espèces de Luxations de la Cuisse.

…

2. Le ligament rond se trouvant plus proche du bord de la cavité du côté interne, la tête de l'os peut s'éloigner plus de ce côté que des autres sans que le ligament s'y oppose.

…

Par des raisons contraires la luxation doit arriver plus rarement en haut. 1° Les bords de la cavité y sont plus élevés. — 2° L'os ne peut être luxé de ce côté que le ligament rond ne soit rompu, et que par conséquent l'effort ne soit très-violent; car, s'il était médiocre, ce ligament , capable d'une certaine résistance , pourrait empêcher l'éloignement de la tête de l'os. — 3° Enfin les muscles les plus puissans s'opposent à cette luxation. 

Quote p. 84

Du Pronostic de la Luaation de la Cuisse.

…

Lorsque la cuisse est luxée en haut, la guérison est difficile et incertaine, quoique la réduction ait été bien faite, ce qui vient de ce que le ligament rond souffre nécessairement rupture dans ces sortes de luxations, et de ce que la réunion ne s'en fait pas toujours, quelque précaution qu'on prenne pour la procurer. 

Quote p. 87

De la Cure de la Luxation de la Cuisse.

…

Les luxations en haut exigent qu'on applique des appareils plus serrés , et qu'on fasse garder le repos beaucoup plus exactement qu'après les autres luxations ; et cela à cause de la rupture du ligament rond, dont la réunion se fait difficilement, et demande un temps considerable. 

Quote p. 91

De la Luxation de la Cuisse qui succède auxchutes du grand Trochanler.

…

Lorsque, dans une chute, le grand trochanter est frappé, la tête du fémur est violemment poussée contre les parois de la cavité cotyloïde ; et , comme elle remplit exactement cette cavité , les cartilages , les glandes de la synovie et le ligament de l'intérieur de l'article doivent souffrir une forte contusion, qui sera suivie d'obstruction, d'inflammation et de dépôt. La synovie surtout s'amassera dans la cavité de l'articulation; la capsule ou tunique ligamenteuse en sera distendue, et la tête de l'os, peu à peu chassée au dehors, sera enfin entièrement luxée.

 '''La synovie s'épanchant continuellement dans l'article, s'y épanchant même alors plus que dans l'état naturel, et n'étant plus dissipée par les mouvemens de la partie, on ne doit point être surpris qu'elle s'accumule, et qu'elle remplisse la cavité au point de chasser la tête de l'os ; ce qu'elle fera avec d'autant plus de facilité que, relâchant les ligamens, elle les met hors d'état de résister non-seulement à la force avec laquelle elle pousse l'os hors de sa boîte, mais encore aux efforts que font les muscles pour tirer en haut la tête du femur. La capsule ne sera donc pas seule distendue, le ligament rond souffrira aussi peu à peu un alongement qui sera accompagné d'une douleur trèsvive, laquelle augmentera par degrés, et ne diminuera que quand ce ligament, tout-à-fait relâché ou rompu, aura abandonné la tête de l'os à toute la puissance des muscles qui la tirent en. 

Quote p. 92

Si la tête de l'os, entièrement chassée de sa cavité, n'est pas d'abord portée plus loin par l'action des muscles, c'estparcequele ligament rond la retient encore; et il est facile de concevoir qu'alors les douleurs doivent augmenter considérablement. En effet, tant que quelque portion de la tête a pu être retenue par le rebord de la cavité yle ligament rond a partagé avec lui l'effort des muscles, et ne-s^.est alongé que peu à peu; mais, la tête du fémur ayant été entièrement chassée, le ligament supporte lui seul l'effort des muscles, les douleurs deviennent insupportables, et durent, comme on l'a déjà dit, jusqu'à ce que la rupture du ligament ou sa relaxation entière ait permis aux muscles d'éloigner l'os autant qu'il peut l'être parleur plus grande contraction. 

External links

Petit JL. Oeuvres completes de J.L. Petit: Maladies des os, maladies chirurgicales. Paris: Frederic Prevost, 1844. [archive.org]

Authors & Affiliations

Jean-Louis Petit (1674-1750) was French surgeon and anatomist. [wikipedia.org]

Jean-Louis Petit
The author of the image is Ambroise Tardieu;
original in the 
wikimedia.org collection (CC0 – Public Domain, no change)

Keywords

ligamentum capitis femoris, ligamentum teres, ligament of head of femur, anatomy, dislocation, injury, pathological anatomy

                                                                    

NB! Fair practice / use: copied for the purposes of criticism, review, comment, research and private study in accordance with Copyright Laws of the US: 17 U.S.C. §107; Copyright Law of the EU: Dir. 2001/29/EC, art.5/3a,d; Copyright Law of the RU: ГК РФ ст.1274/1.1-2,7

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