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Upper extremity of right Femur viewed from behind and above
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Right femur Anterior surface
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The (or '''proximal extremity''') presents for examination a head, a neck, a
Greater Trochanter and a
Lesser Trochanter .
The head which is globular and forms rather more than a hemisphere, is directed upward, medialward, and a little forward, the greater part of its convexity being above and in front.
Its surface is smooth, coated with cartilage in the fresh state, except over an ovoid depression, the
Fovea Capitis Femoris , which is situated a little below and behind the center of the head, and gives attachment to the
Ligamentum Teres .
The neck is a flattened pyramidal process of bone, connecting the head with the body, and forming with the latter a wide angle opening medialward.
The angle is widest in infancy, and becomes lessened during growth, so that at
Puberty it forms a gentle curve from the axis of the body of the bone.
In the adult, the neck forms an angle of about 125° with the body, but this varies in inverse proportion to the development of the pelvis and the stature.
In the
Female , in consequence of the increased width of the pelvis, the neck of the femur forms more nearly a right angle with the body than it does in the
Male .
The angle decreases during the period of growth, but after full growth has been attained it does not usually undergo any change, even in old age; it varies considerably in different persons of the same age.
It is smaller in short than in long bones, and when the pelvis is wide.
In addition to projecting upward and medialward from the body of the femur, the neck also projects somewhat forward; the amount of this forward projection is extremely variable, but on an average is from 12° to 14°.
The neck is flattened from before backward, contracted in the middle, and broader laterally than medially.
The vertical diameter of the lateral half is increased by the obliquity of the lower edge, which slopes downward to join the body at the level of the lesser trochanter, so that it measures one-third more than the antero-posterior diameter.
The medial half is smaller and of a more circular shape.
The anterior surface of the neck is perforated by numerous vascular
Foramina .
Along the upper part of the line of junction of the anterior surface with the head is a shallow groove, best marked in
Elderly subjects; this groove lodges the orbicular fibers of the capsule of the
Hip-joint .
The posterior surface is smooth, and is broader and more concave than the anterior: the posterior part of the capsule of the hip-joint is attached to it about 1 cm. above the
Intertrochanteric Crest .
The superior border is short and thick, and ends laterally at the greater trochanter; its surface is perforated by large foramina.
The inferior border, long and narrow, curves a little backward, to end at the lesser trochanter.
The trochanters are prominent processes which afford leverage to the muscles that rotate the thigh on its axis. They are two in number:
A prominence, of variable size, occurs at the junction of the upper part of the neck with the greater trochanter, and is called the laterally, the
Vastus Lateralis below, and the tendon of the
Obturator Internus and two
Gemelli above.
Running obliquely downward and medialward from the tubercle is the
Intertrochanteric Line (spiral line of the femur); it winds around the medial side of the body of the bone, below the lesser trochanter, and ends about 5 cm. below this eminence in the
Linea Aspera .
Its upper half is rough, and affords attachment to the
Iliofemoral Ligament Of The Hip-joint ; its lower half is less prominent, and gives origin to the upper part of the
Vastus Medialis .
Running obliquely downward and medialward from the summit of the greater trochanter on the posterior surface of the neck is a prominent ridge, the
Intertrochanteric Crest .
Its upper half forms the posterior border of the greater trochanter, and its lower half runs downward and medialward to the lesser trochanter.
A slight ridge is sometimes seen commencing about the middle of the intertrochanteric’ crest, and reaching vertically downward for about 5 cm. along the back part of the body: it is called the
Linea Quadrata , and gives attachment to the
Quadratus Femoris and a few fibers of the
Adductor Magnus .
Generally there is merely a slight thickening about the middle of the intertrochanteric crest, marking the attachment of the upper part of the Quadratus femoris.
