Fragments from the book Reeves HA. Human Morphology: A Treatise on Practical and Applied Anatomy. Vol. 1. (1882). The author describes the anatomy of the ligamentum capitis femoris (LCF) and its role.
Quote pp. 451-452
By arrangement with the dissector of the abdomen, who will
be interested in the observation, the student should carefully trephine or
chisel out a small piece from the roof of the acetabulum in order to observe
what has already been stated with regard to the capsule, and also to note how
the ligamentum teres is affected with regard to its tension or laxity in the
various movements of the joint. He may also try to inject into the joint some
warm tallow so as to note if there be any hernial protrusions or projections of
the synovial membrane between the layers of the capsule, or whether the
synovial membrane of the joint communicates with any of the neighbouring bursæ,
more especially with the psoas bursa.
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| FIG 336. RIGHT HIP JOINT OPENED. The femur is pulled out of the acetabulum. |
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| FIG. 337. PELVIC LIGAMENTS. ANTERIOR VIEW, ONE-FOURTH. The right hip-joint is opened and the femur rotated out. 1. Four lumbar vertebra. 2. Ilium. 2'. Ant. sup. spine. 2". Ant. inf. spine. 3. Ischium. 4. Pubes. 5. Femur. 5'. Head of femur. 5". Femoral neck. 6. Ilio-lumbar lig. 7. Ant. sacro-iliac. 8. Great sciatic. 9. Lesser sciatic. 10. Ant. common lig. 11. Ant. sacro-coccygeal. 12. Subpubic lig. 13. Obturator lig. 14. Symphysis pubis. 15. Ilio-femoral. 16. Pubc-femoral. 17. Capsular. 18. Cotyloid. 19. Lig. teres. 20. Great sacro sciatic foramen. 2'''. Ilio-pectincal line. |
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| FIG. 338. LEFT HIP JOINT OPENED THROUGH THE ROOF OF THE ACETABULUM. |
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| FIG. 339. VERTICAL TRANSVERSE SECTION THROUGH RIGHT HIP JOINT. A. Internal iliac fossa cut. |
Quote pp. 454-457
Dissection. Divide the capsular ligament about half an inch
from the acetabulum. Displace the head of the femur, then the cotyloid ligament
and the ligamentum teres will become evident. Remove the synovial and areolar
tissue, and expose the bifurcated attachment of the ligamentum teres. Clean the
transverse ligament which passes over the notch.
The Ligamentum teres, or interarticular, or round ligament,
is a triangular band of fibres about an inch in length, and is attached by its
apex, which is roundish, to a depression slightly behind and below the centre
of the femoral head. Its broad base is flattened, and divides into two bands.
of fibres which are attached thus: the upper or anterior piece, called the pubic
portion of the ligament, blends with the transverse ligament and is fixed to
the pubic edge of the notch; the posterior lower piece, the ischial portion, is
inserted behind the transverse ligament into the ischial portion of the
cotyloid notch. The strength and thickness of this ligament are variable. It is
surrounded by a tubular process of the synovial membrane; this may exist even
when the ligament is absent. The round ligament checks external rotation and
adduction in the flexed position. It consequently tends to prevent dislocation
forwards and outwards. Mr. Savory, in the Lancet of May 23, 1874, says that the
ligamentum teres is always tense when standing upright, and is further tightened
in standing on one leg, and consequently is of opinion that its main function
is to support and distribute the body weight over the whole surface of the
acetabulum and head of the femur. Some anatomists say that the ligament is lax
when the limb is extended, as then the innominate and femoral attachments are
near each other. If the femur be adducted the ischial portion becomes tense
because the femoral head is raised. If the joint be flexed the ligament becomes
tense, as then the femoral insertion is removed from the acetabular; and the
ligament will be most stretched if, in the flexed condition, the femur be
adducted or rotated out.
Dissection. Divide the ligamentum teres so that the cavity
of the acetabulum and the cotyloid and transverse ligaments may be studied.
The Cotyloid ligament is a narrow fibro-cartilaginous band,
which is attached by its base to the acetabular margin, the inequalities of
which it fills up, and is prolonged across the notch on its inner and lower
side (the ischio-pubic notch), and forms the superficial part of the transverse
ligament. It is thinner at its free margin or apex, where it embraces the head
of the femur. Its outer surface is in contact with the capsular ligament, and
its inner surface is inclined inwards and narrows and deepens the acetabulum.
It is much thicker above than behind, and below than in
front, and its fibres are close and compact, and interlace in various
directions. The inner part of the capsular ligament often blends with the outer
part of the cotyloid.
The Transverse ligament is a strongish narrow band of fibres
which crosses the notch at the lower part of the acetabulum (ischio-pubic), and
converts it into a foramen. It is continuous at the margins of the notch with
the cotyloid, and its superficial part, which is mostly distinct, is a
continuation of the cotyloid over the notch. The deeper fibres are special to
the ligament. Beneath it the nutrient vessels of the joint pass in and out. The
fatty tissue in the joint communicates beneath this ligament with the areolar
tissue outside the joint, so that pus formed within the joint may pass down and
inwards to the thigh and vice versa.
The Joint Surfaces. It will now be clear that the hip joint
is an enarthrodial, or ball-and-socket joint, being the largest and most
perfect of its kind in the human body. It is formed by the head of the femur
fitting into the cavity of the acetabulum.
The Acetabulum is coated with cartilage over the greater
part of its surface excepting where the interarticular mass of fat is lodged
(the socalled gland of Havers), and opposite the ischio-pubic notch. The
articular surface of the acetabulum is deep above, but narrows towards the
notch. The head of the femur, or rather the cartilage covering its head, is in
contact with the acetabular cartilage and the interarticular adipose mass. A
depression a little behind and below its centre will be noticed on the head of
the femur, to this the round ligament is attached; on that part of the
acetabulum uncovered by cartilage is a mass of vascular fatty tissue which is
thicker near the margin of the cartilage than near the transverse ligament, and
which acts as a buffer preventing concussion of the head of the femur against
the thin roof of the acetabulum. This is the so-called gland of Havers.
Synovial Membrane. The synovial membrane of this joint is
extensive, and like all serous membranes is a closed sac. It lines the capsular
ligament and invests the others. If we commence at the margin of the acetabulum
it will be seen to be reflected on the inner surfaces of the capsular, and
reflected along the neck and over the head of the femur, along the ligamentum
teres to the bottom of the acetabulum, and then along the inner side of the
cotyloid ligament, over its outer side to the margin of the acetabulum again.
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| FIG. 340. TRANSVERSE VERTICAL SECTION THROUGH LEFT HIP JOINT. |
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| FIG. 341. VERTICAL TRANSVERSE SECTION THROUGH LEFT HIP. |
External links
Reeves HA. Human Morphology: A Treatise on Practical and
Applied Anatomy. Vol. 1. London:
Smith, Elder, & Company, 1882. [books.google ,
wellcomecollection.org]
Authors
& Affiliations
Henry Albert Reeves (1841?-1914) was a surgeon to the Royal Orthopaedic Hospital, M.R.C.S., F.R.C.S.Ed. [wellcomecollection.org , ncbi.nlm.nih.gov]
Keywords
ligamentum
capitis femoris, ligamentum teres, ligament of head of femur, anatomy, role
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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