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Femur

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Introduction

Anatomy of the femur[1]

Alternative Names

  • Femoral Bone
  • Thigh Bone
  • Os Femoris
  • Upper Leg Bone

General

  • The Femur is the longest and strongest bone in the human body
  • Forms the skeletal framework of the thigh and connects the hip to the knee
  • Major regions include the femoral head, neck, trochanters, shaft, and condyles
  • Serves as an attachment site for major lower extremity muscle groups
  • Essential for weight-bearing, gait, balance, and lower extremity biomechanics

Proximal Femur

Schematic drawing of the facets of the greater trochanter[2]
The greater trochanter and bursa[3]
Human femur bone structure[4]

Greater Trochanter

  • General
    • “Trochanter” means “runner” in Greek
    • Analogous to the greater tubercle of the humerus
    • Peri trochanteric issues analogous to rotator cuff tendons of the shoulder
  • Subgluteus maximus bursa
    • Lateral to the greater trochanter, between the tendons of gluteus maximus and medius
    • Sometimes divided into up to 4 seperate bursa
    • Deep subgluteus maximus bursa: largest, most consistent of these subdivisions, often referred to as the “trochanteric bursa”, implicated in Greater Trochanteric Pain Syndrome
    • Other components include secondary deep, superficial, gluteofemoral
  • Subgluteus medius bursa
    • Up to 3 bursa, largest on anterior surface of greater trochanter
  • Gluteus minimus bursa
    • Minor bursa, deep to the minimus insertion on the anterior aspect of the greater trochanter.
  • Facets

Trochlear Groove

  • Partially responsible for stabilizing patella during knee flexion and extension

Other Structures

  • Peritrochanteric Compartment
    • Contents: "trochanteric bursa"
    • Anterior border: proximal Sartorious, Tensor Fascia Latae
    • Medial border: Gluteus Medius, Gluteus Minimus
    • Lateral border: fibers of Iliotibial Band
    • Inferior border: terminates at the level of the gluteal sling insertion
    • Clinical significance: Portal for hip arthroscopy
  • Lateral Compartment
  • Peripheral compartment

Pediatric Considerations

  • Distal femur physis
    • Characterized by 5 important ridges, notches and peaks that change and evolve with skeletal maturity[5]
    • Composed primarily of cartilage, made up of 3 distinct zones of maturation
    • Contributes an average of 1 cm of annual growth to lower limb
    • Growth occurs until 14-16 in females, 16-18 in males
    • High rate of growth arrest following fracture
  • Significance[6]
    • Contributes to 70% of the growth of the femur
    • Contributes 35-40% of the entire length of the lower limb
    • LCL, MCL attach to the physis
The anatomy of the hip region, including the head, femoral neck, greater trochanter, and lesser trochanter of the proximal femur, and the acetabulum, ilium, ischium, and pubis of the os coxae (pelvic bone)[7]

Intertrochanteric Line

  • Rough ridge on the femur between the greater and lesser trochanters

Muscle Insertion

Actions

  • Femoral neck-shaft axis forms an angle of 120-135°

Vascular Supply

  • General
  • Femoral Neck is tenuous
    • Medial femoral circumflex artery
    • Lateral femoral circumflex artery
    • Artery of the ligamentum teres (minor)

Innervation

Distal Femur

Normal lateral view of the femur[8]

Anatomy

  • Distal portion of the Femur forming the superior aspect of the knee joint
  • Composed of:
    • Medial femoral condyle
    • Lateral femoral condyle
    • Intercondylar notch
    • Patellar (trochlear) groove
    • Medial and lateral epicondyles
  • Covered with thick articular cartilage for load distribution and smooth joint motion
  • Articulates with:

Attachments

  • ACL attaches to the lateral femoral condyle
  • PCL attaches to the medial femoral condyle
  • MCL attaches near the medial epicondyle
  • LCL attaches to the lateral epicondyle
  • Gastrocnemius muscle originates from the posterior condyles
  • Adductor tubercle serves as insertion for adductor magnus

Intercondylar Notch

  • Deep notch between the rear edge of the medial and lateral epicondyle of the femur
  • Anteriorly they are separated by a smooth shallow articular surface for the patella

Function

  • Primary weight-bearing region of the knee
  • Facilitates knee flexion and extension
  • Contributes to rotational stability of the knee
  • Guides patellar tracking through the trochlear groove
  • Distributes forces during walking, running, jumping, and landing
  • Provides attachment points for major stabilizing ligaments and muscles

Clinical Significance

Pelvix XR demonstrating left femoral neck fracture

Proximal

Shaft

Distal

Other

See Also

Proximal

Distal

References

  1. ↑ Image courtesy of //www.britannica.com/, "Femur"
  2. ↑ Malanga, Gerard A., and Kenneth R. Mautner. "Atlas of ultrasound-guided musculoskeletal injections." (No Title) (2014)
  3. ↑ Kaplan, A. H. "Musculoskeletal Sports and Spine Disorders." Musculoskelet Sport Spine Disord (2017): 33-7.
  4. ↑ Hamzah, Adawiya Ali. "Effect of crack on human femur bone under axial load." AIP Conference Proceedings. Vol. 2404. No. 1. AIP Publishing LLC, 2021.
  5. ↑ Liu, Raymond W., et al. "An anatomic study of the distal femoral epiphysis." Journal of Pediatric Orthopaedics 33.7 (2013): 743-749.
  6. ↑ Moran, M., and M. F. Macnicol. "(ii) Paediatric epiphyseal fractures around the knee." Current Orthopaedics 20.4 (2006): 256-265.
  7. ↑ Cole, Raymond E. "Improving clinical decisions for women at risk of osteoporosis: dual-femur bone mineral density testing." The Journal of the American Osteopathic Association 108.6 (2008): 289-295.
  8. ↑ Case courtesy of Amanda Er, Radiopaedia.org, rID: 79974
Created by:
John Kiel on 27 June 2020 15:44:00
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Last edited:
3 June 2026 17:40:03
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