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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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