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HIP COMPLEX. Review Bony Articular Surfaces. Synovial ball and socket joint: Femoral head. Acetabular fossa. Lunate surface. Arranged to favor stability over mobility. Three degrees of freedom. Sciatic Notches. Separated from each other by ischial spine. Ligaments:

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Review bony articular surfaces
Review Bony Articular Surfaces

  • Synovial ball and socket joint:

    Femoral head.

    Acetabular fossa.

    Lunate surface.

  • Arranged to favor stability over mobility.

  • Three degrees of freedom.


Sciatic notches
Sciatic Notches

  • Separated from each other by ischial spine.

    Ligaments:

    Sacrospinous.

    Sacrotuberous.

    Convert notches into foramina:

    Greater sciatic foramen for structures entering or leaving pelvis.

    Lesser sciatic foramen for structures entering or leaving the perineum.


Joint capsule and ligaments
Joint Capsule and Ligaments

  • Acetabular labrum:

    Fibrocartilage.

    Deepens acetabular socket.

    Grips head of femur.

  • Transverse acetabular ligament:

    Continuation of acetabular labrum across acetabular notch.

    Converts notch into a foramen for the transmission of the artery to the head of the femur.


Joint capsule and ligaments1
Joint Capsule and Ligaments

  • Fibrous capsule of joint is tight.

  • Encloses head and most of femoral neck.

  • Proximal attachment:

    Acetabulum and transverse acetabular ligament.

  • Distal attachment:

    Greater trochanter and intertrochanteric line.


Joint capsule and ligaments2
Joint Capsule and Ligaments

  • Iliofemoral ligament:

    Strongest and most important ligament of the hip joint.

    Called the “Y” ligament of Bigelow.

    Proximal attachment:

    Anterior inferior iliac spine.

    Distal attachment:

    Intertrochanteric line.

    Resists hyperextension of the hip.


Joint capsule and ligaments3
Joint Capsule and Ligaments

  • Pubofemoral ligament:

    Proximal attachment:

    Pubis near inferior rim of acetabulum.

    Distal attachment:

    Neck of femur above lesser trochanter.

    Resists hyperextension of the hip.


Joint capsule and ligaments4
Joint Capsule and Ligaments

  • Ischiofemoral ligament:

    Proximal attachment:

    Ischium near posterior rim of acetabulum.

    Distal attachment:

    Neck of femur medial to greater trochanter.

    Resists hyperextension of the hip.


Joint capsule and ligaments5
Joint Capsule and Ligaments

  • Ligamentum teres:

    Proximal attachment:

    Fovea of femoral head.

    Distal attachment:

    Transverse acetabular ligament.

    Supports artery to the head of the femur.

  • Zona orbicularis:

    A collar-like ligament around the distal neck of the femur.


Blood and nerve supply
Blood and Nerve Supply

  • Nerve supply:

    Mostly supplied by branches of the:

    Femoral nerve.

    Obturator nerve.

  • Blood supply:

    Superior and inferior gluteal arteries.

    Medial and lateral femoral circumflex arteries.

    Obturator arteries.


Angulations
Angulations

  • Angle of inclination:

    Axis of femoral neck.

    Axis of femoral shaft.

    Angle value:

    Infant = 150 degrees.

    Adult = 125 degrees.

    Elderly = 120 degrees.


Angulations1
Angulations

  • Angle of inclination:

    Pathologies:

    Increase = coxa valga.

    Decrease = coxa vara.


Angulations2
Angulations

  • Angle of torsion:

    Transverse axis of femoral condyles.

    Axis of femoral neck.

    Angle value:

    12 degrees (range = 8 – 25 degrees).


Angulations3
Angulations

  • Angle of torsion:

    Pathologies:

    Increase = anteversion.

    Anterior surface of femur faces more medially.

    Decrease = retroversion.

    Anterior surface of femur faces more laterally.


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