Femur

Femur (Latin osfemoris) – the largest and long tubular bone of a skeleton of the person serving as the lever of the movement. Her body has a little bent and twisted on an axis cylindrical form expanded from top to bottom. The front surface of a femur smooth, back – rough, serving as the place of an attachment of muscles. It is subdivided into lateral and medial bays which are closer to the middle of a femur прилежат to each other closely, and from top to bottom and up disperse.

The lateral lip from top to bottom considerably is thickened and extends, turning into buttock tuberosity – the place to which the big gluteus fastens. The medial lip goes down below, turning into the rough line. At the very bottom of a lip femur gradually move away, limiting to themselves a subnodal surface of triangular shape.

The distal (lower) end of a femur is a little expanded and forms two roundish and enough large a condyle, differing from each other by the size and degree of curvature. Concerning each other they are located at one level: each of them separates from "fellow" a deep intercondyloid pole. Joint surfaces of condyles form a concave patellar surface to which prilezhit a patella the back party.

Femur head

The head of a femur is based upon an upper proximal epiphysis, connecting to other bone by means of the neck remote from an axis of a shaft of the femur at an angle 114-153 degrees. At women, thanks to the bigger width of a basin, the tilt angle of a neck of a femur approaches direct.

On borders of transition of a neck to a shaft of the femur there are two powerful hillocks which are called spits. The arrangement of a big spit lateral, on its median surface is a trochanterian pole. The trochantin is from below from a neck, holding in relation to it medial position. In front both spits – both big, and small – connect an intertrochanteric crest.

Femur fracture

Fracture of a femur is called the state which is characterized by disturbance of its anatomic integrity. Most often, it happens at elderly people, when falling sideways. Concurrent factors of fractures of hip in these cases are the reduced tone of muscles, and also osteoporosis.

Symptoms of a fracture are sharp pain, puffiness, dysfunction and deformation of an extremity. Trochanterian changes are characterized by more megalgias which amplify in attempt of the movement and palpation. The main symptom of a fracture an upper part (neck) of a hip – "a symptom of the stuck heel" – a state at which the patient cannot turn a leg at right angle.

Fractures of a femur are subdivided on:

• Extraarticular which, in turn, share on driven (abduction), not driven (adduktsionny), trochanterian (intertrochanteric and chrezvertelny);
• Intra joint to which the change of a head of a femur and a fracture of a neck of a hip belong.

Besides, in traumatology allocate the following types of intra joint fractures of hip:

• Capital. In this case the line of a change mentions a hip head;
• Subcapital. The place of a change is located under its head at once;
• Transcervical (chrezsheechny). The line of a change is in area of a neck of a hip;
• Bazistservikalny at whom the place of a change is located on border of a neck and a shaft of the femur.

If changes are driven when fragment of a femur puts in other bone, conservative treatment practices: the patient keeps within on a bed with the wooden board enclosed under a mattress, at the same time the injured leg is based upon Beller's tire. Further skeletal traction for condyles of a shin and hip is carried out.

In case of the displaced changes which are characterized by deformation and vicious position of an extremity carrying out operation is recommended.

Femur necrosis

Femur necrosis – a serious illness which develops owing to disturbance of structure, food or fatty dystrophy of a bone tissue. The main reason for the pathological process developing in structure of a femur – disturbance of microblood circulation, processes of bone formation and, as a result, dying off of cells of a bone tissue.

Distinguish 4 stages of a necrosis of a femur:

• The I stage is characterized by the periodic pains giving to the inguinal area. At this stage there is a defeat of spongy substance of a head of a femur;
• Iistadiya differs in severe constant pains which do not disappear at rest. Radiological a golovkabedrenny bone it is speckled small as if an egg shell, cracks;
• The III stage is followed by an atrophy of gluteuses and muscles of a hip, the shift of a buttock fold, shortening of the lower extremity is observed. Structural changes make about 30-50%, the person is inclined to lameness and uses a cane for movement.
• The IV stage - time when the hip head completely collapses that leads to the patient's invalidism.

Emergence of a necrosis of a femur is promoted:

• Injuries of a hip joint (especially at a femur head change);
• The home accidents and overloads of accumulative character received at sports activities or exercise stresses;
• Toxic influence of some drugs;
• Stresses, alcohol abuse;
• Congenital dislocation (dysplasia) of a hip;
• Diseases of a bone tissue, such as osteoporosis, osteosinging, system lupus erythematosus, pseudorheumatism;
• Inflammatory, catarrhal diseases which are followed by endothelial dysfunction.

The technique of treatment of a necrosis of a femur depends on a stage of a disease, its character, age and specific features of the patient. Today the drugs allowing to recover fully blood circulation in a hip head do not exist therefore recovery of body is carried out, most often, by surgical methods. Treat them:

• Femur decompression – drilling in a head of a hip of several channels in which vessels begin to be formed and grow;
• Change of a transplant from a fibular bone;
• Endoprosthesis replacement at which the destroyed joint is replaced with a mechanical design.