FEMUR

FEMUR - Development and Growth:

• 📌The femur develops from cartilage in the fetal period and ossifies in childhood.

• 📌Its growth plate (epiphyseal plate) is located at the proximal end, and its fusion marks the end of bone lengthening during adolescence.

• 📌The femoral head and neck are typically the last parts of the femur to fully ossify, making them particularly vulnerable to fractures in older adults.

Clinical Considerations (Additional):

• 📌Femoral Shaft Fractures:

  • 🔺Fractures of the femoral shaft are often caused by high-energy trauma, such as car accidents or falls from height.

  • 🔺They require surgical intervention, typically with intramedullary nailing, due to the large amount of force involved and the risk of fat embolism.

• 📌Leg Length Discrepancy:

  • 🔺Fractures or surgical procedures affecting the femur may result in a leg length discrepancy, which can affect gait and cause compensatory scoliosis or pelvic tilt.

• 📌Hip Osteoarthritis:

  • 🔺Degenerative changes in the femoral head (often seen in hip osteoarthritis) can lead to pain, limited motion, and reduced function.

  • 🔺Total hip arthroplasty is a common treatment in such cases.

• 📌Trochanteric Bursitis:

  • 🔺Inflammation of the bursa located near the greater trochanter (trochanteric bursitis) can cause pain, particularly with activities like walking, running, or climbing stairs.

Muscle Attachments and Movements:

• 📌Gluteus Medius and Minimus:

  • 🔺Both the gluteus medius and minimus, which originate from the ilium and insert onto the greater trochanter, are critical for stabilizing the pelvis during walking and preventing the pelvis from tilting when standing on one leg.

• 📌Hamstrings and Hip Extension:

  • 🔺While the hamstrings (semitendinosus, semimembranosus, and biceps femoris) are primarily knee flexors, the biceps femoris also plays a role in hip extension when the hip is flexed.

• 📌Adductor Muscles:

  • 🔺The adductor muscles, which originate from the pubis and insert on the femur, contribute to adduction of the thigh.

  • 🔺They are also involved in maintaining pelvic stability during locomotion.

Clinical Imaging:

• 📌X-ray and CT scans are commonly used to evaluate fractures, joint abnormalities, and degenerative changes in the femur and hip joint.

• 📌MRI is particularly useful in detecting soft tissue injuries around the femur, such as muscle tears or ligament injuries.

Femoral Nerve Block:

• 📌A femoral nerve block is commonly performed to provide analgesia for procedures involving the femur, hip, or knee.

• 📌The femoral nerve, a branch of the lumbar plexus, supplies motor innervation to the hip flexors and sensory innervation to the anterior and medial thigh.

Anatomical Variations:

• 📌Femoral Anteversion (excessive forward rotation of the femoral neck) can cause an in-toeing gait in children.

• 📌Femoral Retroversion (excessive backward rotation) may lead to an out-toeing gait.

Bone Marrow and Stem Cell Research:

• 📌The femur is a primary site for bone marrow harvesting in patients requiring stem cell therapy, particularly for hematopoietic stem cell transplants.

Femoral Artery and Surgical Access:

• 📌The femoral artery is a crucial landmark for catheterization, particularly in cardiological procedures such as angiography and stenting.

• 📌It is also a critical site for the insertion of central venous catheters and temporary pacemakers.

Biomechanics and Gait:

• 📌The femur's long axis and the alignment of the hip, knee, and ankle joints are essential for efficient and stable movement during walking, running, and jumping.

• 📌Femoral alignment affects the distribution of forces across the lower extremity and influences gait patterns.