Fragments from the book Frazer JES. Anatomy of the Human Skeleton (1920). The author describes anatomy, embryology, development, and attachment of the ligamentum capitis femoris (LCF).
Quote p. 126-127
The articular surface of the acetabulum surrounds on
three sides the non-articular cotyloid or acetabular fossa, which contains the
fatty tissue of the “ Haversian gland,” and opens below at the cotyloid notch.
The notch is bridged across by the transverse ligament, a tendinous structure
continuous with the fibro-cartilaginous cotyloid ligament that is attached to
the whole length of the edge of the brim : vessels and nerves pass through the
notch, under the transverse ligament, to enter the ligamentum teres. The
fibrous basis of the ligamentum teres is attached to the ischial and iliac
parts of the cotyloid fossa and to the transverse ligament : its synovial
covering is attached to the whole margin of the fossa and the whole length of
the transverse ligament below, covering the fossa but lying free on its
surface. The round ligament is the remains of the original ventral wall of the
capsule (Fig. 106). In the human embryo the Ischium and Ilium alone are
concerned in the articulation with the femur and the capsule is attached round
their ventral margin : the pubic cartilage is extracapsular. As the pubis
extends it is still separated by the cellular capsule from the femur. Later it
breaks through this capsule and becomes articular, the synovial cavity extending
over it from the Ilium. In this way the original attachment of the capsule is
only left on the Ischium as the fibrous basis of the Ligamentum teres. In the
adult the pubic articular surface is still more or less distinct from the iliac
surface, and the same distinction is usually marked on the rim by a shallow
notch ; here the communication may take place of the joint with the sub-psoas
bursa, between the Iliac and pubic parts of the capsule. Above this notch is
the large rough area for the A-shaped Ilio-femoral band, spreading on to the
lower half or more of the anterior inferior spine, and below and internal to it
is the area for the pubo-femoral band which extends inward along the front edge
of the upper pubic ramus, overhanging the issuing obturator nerve.
The direct tendon of the Rectus femoris is attached to
the upper part of the anterior inferior spine, so that it rests on the
ilio-femoral band at its origin : outside this the line of its attachment
passes downwards and backwards, to run into the cotyloid ligament and capsule
at the top of the acetabulum, thus forming the reflected head. Observe that
this must be under cover of Gluteus minimus, arising above the inferior curved
line (see Fig. 105).
At the back of the acetabulum synovial membrane comes
over the cotyloid ligament and touches the bone : this occurs from the
transverse ligament below to the reflected tendon of Rectus above. In front the
synovial membrane does not transgress the cotyloid ligament, but passes nearly
directly from it to the strong capsule.
There is only a slight capsular attachment behind the
acetabulum, for there are no true transverse fibres on the back of the joint,
and only a few of the inner marginal fibres of the circular group run to the
bone in this region : a group of these below reach the upper ramus of ischium
as the “ ischio-capsular band.”
The posterior surface of the acetabular mass is
covered by Pyriformis, and may give origin to some fibres of Gluteus minimus
deep to this : the sciatic nerves, etc., and nerve to Quadratus femoris pass
down on it. The thin floor of the acetabulum is occasionally, like the thinnest
part of the iliac fossa, found to be perforated, and the hole is then closed by
membrane.
Fig. 106. — To illustrate the formation of the
ligamentum teres. In its early stage the ilium (il) and ischium (is) are alone
concerned in the articulation, the synovial lining passing off them on to the
capsule which is attached round their surfaces. The pubis is covered by these
fibres and has no articular area. In the next stage the covering fibres are
destroyed and the pubis has acquired an articular surface (p). This extends,
and the front part of the original ischial capsule is caught, so to speak,
between the extending surface and the ischium; these fibres persist and remain
attached to the ischial region, but on their surface the synovial cavity has
extended, as shown in the last diagram, and has joined the older cavity below
as well, passing between the femur and the lower portion of the attached
capsule. Thus a synovial funnel is formed, wider below where it includes the
attachment of the fibres and narrowed at its femoral end, where it is fastened
to the fovea.
Fig. 107. — Postero-external aspect of right os
innominatum. The curved lines are somewhat diagrammatically drawn : for account
see the text. Some of the fibres of the great sciatic ligament run on to the
surface of the bone round x, and give origin here to part of G. maximus. The
position of the sacrum and great ligament is indicated, with the origin of the
muscle from it. A is the surface below the inferior curved line, covered by G.
min. ; B, the area covered by Pyriformis, with the great sciatic nerve
interposed ; C, covered by Obturator internus and Gemelli, which lie between
the nerve and the bone, but have the' nerve to Quadratus between them and the
bone. The muscles mentioned are practically in a continuous curved plane, so
that the areas A, B, and C make a convex surface, continuously curved and
smooth, round the acetabulum ; the muscles pass to the raised trochanter, so do
not mould the bone by pressure. The lower aspect of the tuber ischii, below the
facets for the hamstring muscles, shows two sloping surfaces, of which one
looks outwards and gives origin to fibres of Adductor magnus (ischio-condylar
portion), while the other looks inwards (D) and is covered by fibrofatty tissue
which is continuous round the great sacro-sciatic ligament with that of the
ischio-rectal fossa : in this tissue is a badly-defined bursa which lies under
the tuberosity in sitting, the hamstrings and Adductor moving to the outer side
of the prominence when the limbs are bent for that purpose.
Quote p. 142-143
The Ligamentum teres is a weak synovial attachment of
the head of the femur to the cotyloid fossa and transverse ligament: it is (p.
127) the remains of the primitive capsule isolated by the secondary taking up
of the pubic surface into the joint, and has little mechanical value, but carries
some small vessels and nerves to the head of the bone.
Fig. 118.Upper end of right femur. The epiphysial line
for the great trochanter is marked in green round its base. The “retinacula of
Weitbrecht,” fibres running back toward the head under the synovial membrane,
are shown only where they are congregated into their three main groups; they
are derived from the transverse capsular fibres, and the upper one obtains many
fibres from Pyriformis (see Fig. 117). 1. Anterior aspect. Observe that the Gluteus
minimus is attached only to the outer ridge of the trochanter, but its tendon
is continuous below with an aponeurotic sheet, the ilio-trochanteric band,
which covers the bursa in front and reaches the bone internal to it. The upper
part of the origin of Crureus is mainly tendinous. The extension of the
cartilage of the head on to the neck is shown at x ; this lies under the
ilio-femoral band or, if the opening for the sub-Psoas bursa is large, under
the tendon of the Psoas. 2. From the outer side. The oblique insertion of
Gluteus medius is continuous below and in front with that of Gluteus minimus,
and frequently with that of Pyriformis above and behind ; it divides this
aspect of the trochanter into two areas, one, C, in front and above, under
cover of medius and therefore bevelled off in the direction of that muscle, the
other. A, below and behind, covered by Gluteus maximus and therefore moulded by
that muscle so that it is more vertically directed and curved from before
backwards. The surface C carries a bursa? but A has only occasionally an
extension of the bursa situated below in relation with it. B, surface covered
by Vastus externus and more or less flattened by it. Crureus fuses with V.
externus at a lower level. 3. Posterior aspect. D, surface covered by Quadratus
femoris; deep to this muscle the Obturator externus lies against the bone,
moulding the back and lower part of the neck in the area F as it passes to the
digital fossa. 4. From the inner side. Observe the pointed area between the spiral
line and pectineal line which is occupied by iliacus. E, inner surface, covered
by Vastus internus but not affording origin to it; the Crureus does not
transgress the inner border.
External
links
Frazer JES. Anatomy of the Human Skeleton. 2nd ed.,
London: J. & A. Churchill, 1920. archive.org , wellcomecollection.org
Authors
& Affiliations
John Ernest Sullivan Frazer (1870-1946) was a British
surgeon, anatomist, and professor of anatomy at the University of London. livesonline.rcseng.ac.uk
Keywords
ligamentum
capitis femoris, ligamentum teres, ligament of head of femur, anatomy,
embryology, development, attachment
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