36o 



HUMAN ANATOMY. 



foetus or infant. Its growth seems to be slight during the first three weeks after 

 birth. The neck grows as a part of the shaft and receives three epiphyses, — one for 

 each trochanter and one for the head, which fits over it hke a cap. The latter 

 appears in the second half of the first year/ and is pretty conclusive evidence that 

 the age of six months at least has been reached. The epiphysis for the greater 

 trochanter comes in the third year (sometimes sonje years later), and that for the 

 lesser at a time variously stated as from eight to fourteen years. It is probable that 



Fig. 376. 



Ossification of femur. ^, at eighth foetal month; B. at birth; C during first year; Z*, at eight years; £■, at 

 about fifteen years, a, centre for shaft; b, lower epiphysis; c, for head; d, for greater trochanter; e, for lesser 

 trochanter. 



the former is much nearer the mark. The head unites with the shaft at about 

 eighteen, the trochanters somewhat later ; probably there are great variations ; but 

 all these superior epiphyses should be joined by nineteen, and at twenty the line of 

 union is indistinct or lost. An epiphysis for the third trochanter has been seen. 

 The lower epiphysis is joined by twenty, and often sooner. At birth the angle of 

 the neck may be 160°, but is often less ; it diminishes under the pressure of the 

 weight as the child walks, and by the time of puberty has probably assumed about 

 its permanent angle. There is no reason to believe that the angle diminishes in 

 old age. 



Surface Anatomy. — The greater trochanter can be explored when the muscles 

 about it are relaxed. The lesser trochanter, though deep, can be felt from behind, 

 A large third trochanter can be recognized, and must not be mistaken for a tumor. 

 Owing to the individual variations of the neck and the pelvis, the relations of the 

 trochanter must vary. According to Langer, a horizontal line at the top of the 

 greater trochanter divides the head, touches the top of the symphysis, and about 

 divides the nates. This is particularly true of broad pelves, and therefore of women. 

 We have found from measurements of 118 males and 37 females that the trochanter 

 is I.I centimetres, on the average, higher than the symphysis in the male and three 

 millimetres in the female. Topinard gives as provisional distances in the male the 

 following : the anterior superior spine of the ilium is six centimetres above the head 

 of the femur, the latter two centimetres above the greater trochanter (practically 

 agreeing with Langer), and the greater trochanter two centimetres above the pubes. 

 The head of the femur lies under a crease beneath the proper fold of the groin, and 

 can sometimes be distinguished at the inner side of the sartorius. Nelaton's line is 

 drawn from the anterior superior spine of the ilium to the most prominent point of 

 the tuberosity of the ischium. It should just touch the top of the greater trochanter. 

 The shaft is too thickly covered to be examined in detail, except near the knee. The 

 sides of both condyles are easily examined ; the lateral tubercles and the adductor 



' Fagerlund : Wiener Med. Presse, 1890. 



