Femur

Question 1

Anatomical location

Answer 1

Only bone in thigh

Classed as long bone (longest bone in body)

Question 2

Proximal femur

Answer 2

Forms hip joint with pelvis

• Head - smooth surface with depression on medial surface (for attachment of ligament), articulates with acetabulum of pelvis
• Neck - connects head to shaft, projects in superior/medial direction (allows for increased range of movement at hip)
• Greater trochanter - projection of bone which originates from anterior shaft (lateral to where neck joins), angles superior/posterior and can be found on both sides of femur, site of attachment of abductor and lateral rotator muscles of the leg
• Lesser trochanter - projects from posteromedial side inferior to neck-shaft junction, psoas major and iliacus muscles attach here
• Intertrochanteric line - ridge of bone runs inferomedial direction on anterior surface, connects trochanters, iliofemoral ligament attaches here, known as pectineal line after it passes lesser trochanter
• Intertrochanteric crest - ridge of bone connecting two trochanters on posterior surface, there is a rounded tubercle on its superior half (quadrate tubercle - attachment of quadratus femoris)

Question 3

Proximal femur fractures

Answer 3

• Intracapsular fracture - common in elderly women, result of minor trip/stumble, occurs within capsule, can damage medial femoral circumflex artery -> avascular necrosis of femoral head, leg shortened and laterally rotated
• Extracapsular fracture - more common in young and middle aged, blood supply to head intact so no avascular necrosis, leg shortened and laterally rotated

Question 4

Shaft

Answer 4

Descends in a slight medial direction, brings knees closer to body’s centre of gravity -> inc. stability
Posterior surface - roughened ridges of bone (linea aspera), proximally the medial border becomes pectineal line and lateral border becomes gluteal tuberosity (where glut. maximus attaches)
Distally widens and becomes floor of popliteal fossa, medial/lateral border -> medial/lateral supracondylar lines

Question 5

Femoral shaft fracture

Answer 5

Relatively uncommon, require a lot of force
Consequence of traumatic injury - vehicular accident
- Spiral fracture - leg shortening (fragments override pulled by attached muscles)
Soft tissue may also be damaged
Sequelae - femoral nerve palsy
Important to ensure femoral artery supply isn’t compromised

Question 6

Distal

Answer 6

• Medial/lateral condyles - rounded areas of femur, posterior and inferior surfaces articulate with tibia and menisci of knee, anterior surface articulates with patella
• Medial/lateral epicondyles - bony elevations on the non articular areas of the condyles, attachments of some muscles and collateral ligaments of the knee
• Intercondylar fossa depression found on posterior surface of femur, lies between 2 condyles, contains 2 facets for attachment of internal knee ligaments
• Facet for attachment of posterior cruciate ligament - found on medial wall of intercondylar fossa
• Facet for attachment of anterior cruciate ligament - found on lateral wall of intercondylar fossa