The femur (Lat. Osfemoris) -The most large and long bones of the human skeleton, which serves lever movement. Her body
has several curved and twisted along the axis of a cylindrical shape extended downward. The front surface of the femur is smooth, the back - rough, serves the attachment of muscles. It is subdivided into lateral and medial lip which is closer to the middle of the femur are adjacent to each other closely, and diverge downwardly and upwardly.
The lateral lip down significantly expands and thickens, going into the gluteal tuberosity - a place which is attached to the gluteus maximus. The medial lip down below, turning into a rough line. At the bottom of the femur lips slowly drifting limiting popliteal surface of a triangular shape.
The distal (lower) end of the femur and more extended forms two rounded and fairly large condyle, differing from each other in size and degree of curvature. Relative to each other, they are located on the same level: each of them is separated from his "brother" deep intercondylar fossa. Articular condyles form a concave patellar surface, which is adjacent to the back side of his kneecap.
The head of the femur
The femoral head is resting on the top of the proximal epiphysis, connecting with the rest of the bone by a neck separated from the body axis of the femoral angle 114-153 degrees. In women, due to the greater width of the pelvic angle of the femoral neck coming in direct.
On the borders of the transition to the neck of the body of the femur are two powerful hill called skewers. Location of the greater trochanter laterally on its middle surface is trochanteric fossa. The lesser trochanter is below the neck, holding on to her medial position. Front two skewers - and big and small - are connected to the intertrochanteric crest.
Fracture of femur
Fractures of the femur is a condition characterized by violation of its anatomical integrity. Most often, it occurs in the elderly, when falling on its side. Associated factors of hip fractures in these cases is to reduce muscle tone, as well as osteoporosis.
Signs of fracture are sharp pain, swelling, dysfunction and limb deformities. Trochanteric fractures are characterized by intense pain, which intensified when attempting movement and feeling. The main sign of fracture of the upper part (cervical), femur - "sign adhering heel" - a condition where the patient is unable to rotate the leg at a right angle.
Fractures of the femur is divided into:
- Extra-articular, which in turn are divided into impacted (abduction) is not impacted (adduktsionnye), spit (intertrochanteric and pertrochanteric);
- Intra, which include fracture of the femoral head and hip fracture.
In addition, the following types of trauma intra-articular fractures of the hip:
- Thorough. In this case, the fracture line involves the head of the thigh;
- Subcapital. The fracture site is located immediately under his head;
- Transcervical (chrezsheechny). The fracture line is in the hip;
- Bazistservikalny, wherein the fracture site is located at the border of the body and neck of the femur.
If fractures are impacted when the fragment of the femur bone is wedged into another, is practiced conservative treatment: the patient is placed on a bed with padded wooden shield under the mattress, and the damaged leg rests on the bus Beller. Further carried skeletal traction for condyles tibia and femur.
In the case of displaced fractures and deformity characterized by a vicious position of the limbs, it is recommended an operation.
Necrosis of the femoral
Necrosis of the femoral - a serious illness that develops as a result of violations of the structure, supply or
steatosis bone. The main reason for the pathological process of developing the structure of the femur - a violation of microcirculation, the processes of bone formation and, consequently, cell death of bone tissue.
There are 4 stages of necrosis of the femur:
- Stage I is characterized by periodic pain radiating to the groin. At this stage, the defeat of the spongy substance of the femoral head;
- IIstadiya characterized by strong constant pains which do not disappear at rest. Radiologically golovkabedrennoy dotted with small bones, like an eggshell, cracked;
- Stage III is accompanied by atrophy of the gluteus and thigh muscles, there is a shift of the gluteal fold, the shortening of the lower limb. Structural changes are about 30-50%, the person tends to limp and uses a cane to move.
- Stage IV - a time when the femoral head is completely destroyed, leading to disability of the patient.
The emergence of necrosis of the femoral contribute:
- Injury of the hip (especially at the turn of the femoral head);
- Personal injury and overload cumulative obtained in sports or physical activities;
- The toxic effects of certain drugs;
- Stress, alcohol abuse;
- Congenital dislocation (dysplasia) of the thigh;
- Bone diseases such as osteoporosis, osteopenia, systemic lupus erythematosus, rheumatoid arthritis;
- Inflammatory, colds, accompanied by endothelial dysfunction.
Methods of treatment of necrosis of the femoral depends on the stage of the disease, its character, age and individual characteristics of the patient. To date medications, allowing to fully restore blood flow in the femoral head, does not exist, therefore the restoration of the body, most commonly performed surgical methods. These include:
- Decompression of the femur - the thigh piercing in the head multiple channels within which begin to form and grow blood vessels;
- Transplant transplant from the fibula;
- Endoprosthesis, in which the destroyed joint is replaced by a mechanical design.