Fragments from the book: Frazer JES. The anatomy of the human skeleton (1920). The author describes the attachment and development of the ligamentum capitis femoris (LCF), as well as its role as a vascular and nerve conductor. The text in Russian is available at the following link: 1920FrazerJES.
Fig. 104. — Outer view of the acetabular and ischio-pubic regions. A. is a region on the bone in front of the position of Quadratus femoris which is in relation with the tendon of Obturator externus and some loose fibro-fatty tissue that permits changes in place of the tendon with movement of the joint. B. is a sloping surface of bone which supports Pectineus but does not give origin to it; the surface extends out to the ilio-pectineal eminence where the fascia covering the Pectineus (pubic portion of fascia lata) reaches the bone at a. The front of the eminence is roughened by fibres belonging to the pubo-femoral group of ligaments. These are separated from the ilio-femoral set by an interval, apparent on the bone and marking the limit of the secondarily added pubic area of articular surface (see Fig. 106), where the synovial cavity is protruded as the sub-psoas bursa ; this is seen in the smaller figure. The Psoas lies on the bursa and the surface C. D. is covered by Gluteus minimus, which arises above the dotted line ; below D. the muscle lies on the reflected head of the Rectus and the capsule of the joint. O. and J.C. are branches of the obturator and internal circumflex arteries anastomosing round Obturator externus and giving twigs through the cotyloid notch into the cotyloid fossa and so into the lig. teres, which is attached round the margins of the fossa and to the transverse ligament that extends between the lips of the notch. X. marks an ill-defined depression on the margin, which indicates the spot where the origin of Adductor magnus passes from the outer side of the pubic ramus to the lower aspect of the ischial tuberosity ; it therefore also marks the hinder limit of origin of Gracilis.
Quote pp. 125-126.
The Acetabular Region (Fig. 104). — It has already been said that the three
main elements of the bone are all represented in the acetabulum. The Ischium is
credited with forming rather more than two-fifths, the Ilium with rather Jess than
this, while the pubis accounts for the remaining fifth. But as a matter of fact
the triradiate cartilage that separates these elements, almost till puberty, develops
a variable number of small ossifying centres in the floor of the acetabulum: these
may fuse to form a small separate bone, the os acetabuli, but in any case there
is ultimate junction of the various parts, and the acetabular centres are usually
described as forming a part of the pubic element.
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.
Fig. 105. — Posterior view of the capsule of hip, showing the circular fibres and reflected tendon of Rectus; this sends some fibres to the circular band.
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| 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 né 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, parang 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. |
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Fig. 107. — Postero-external aspect of right os innominatum. The curved lines are somewhat diagram- matically 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 ow wed 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 pp. 138-139.
The upper end includes head, neck, and two trochanters. The head is connected
with the shaft by the elongated neck, which is directed upwards and inwards and
somewhat forwards,* forming an angle of about 125 degrees with the shaft. The head
is about two-thirds of a sphere, and has on it a depression, the fovea femoris,
for the attachment of the round ligament of the joint. The neck expands towards
the shaft and is overhung externally by the great trochanter: there is a deep digital
fossa under, cover of the back part of this, for the insertion of Obturator externus.
The great trochanter is for the attachment of muscles of the gluteal group.
* Variable in amount of rotation; may be even directed slightly backwards.
Quote pp. 141-142.
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.
External links
Frazer JES. The anatomy of the human skeleton. 2nd ed., London: J. &
А. Churchill, 1920. archive.org
Authors & Affiliations
John Ernest Sullivan Frazer (1870-1946) Professor of Anatomy in the University of London. embryology.med.unsw.edu.au
Keywords
ligamentum capitis femoris, ligamentum teres, ligament of head of femur, anatomy, blood supply, development, attachment, conductor
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