244 



OSTEOLOGY. 



PATELLAR SURFACE 



The articular surface on the distal extremity is divisible into three parts 

 that which corresponds to the distal surface of the body and is formed by the 

 coalescence of the two condyles in front ; and those which overlie the distal and 

 posterior aspects of each of those processes. The former is separated from the latter 

 by two shallow oblique grooves which traverse the articular surface from before 

 backwards, on either side, in the direction of the anterior part of the intercondyloid 

 fossa. These furrows are the impressions in which fit the anterior parts of the 

 medial and lateral menisci of the knee-joint, respectively, when the knee-joint 

 is extended. The anterior articular area or patellar surface is adapted for 

 articulation with the patella. Convex proximo-distally, it displays a broad and 

 shallow central groove, bounded on either side by two slightly convex surfaces. 

 Of the two sides, the lateral is the wider and more prominent, and rises on the 

 front of the bone to a more proximal level than the medial, thus tending to 

 prevent lateral dislocation of the patella. The condylar or tibial surfaces are convex 

 from side to side, and convex from before backwards. Sweeping round the distal 

 surface and posterior extremities of the condyles, they describe a spiral curve more 

 open in front than behind. The medial condylar articular surface is narrower 



than the lateral, and 

 when its distal aspect is 

 viewed it is seen to de- 

 scribe a curve around a 

 vertical axis. Along the 

 lateral edge of this, and 

 in front, where it bounds 

 the intercondyloid fossa, is 

 a semilunar articular area, 

 best seen when the bone 

 is coated with cartilage. 

 This articulates with the 

 medial edge of the patella 

 in extreme flexion of the 

 joint. The articular sur- 

 face of the lateral con- 

 dyle is inclined obliquely from before backwards and slightly laterally. The 

 surfaces of the condyles proximal to the articular area posteriorly are continuous 

 with the popliteal surface of the shaft. The area from which the medial head of the 

 muscle springs is often elevated in the form of a tubercle placed on the distal part 

 of the popliteal surface of the body, just proximal to the medial condyle. 



The proportionate length of the femur to the body height is as 1 is to 3 -5 3-3 '9 2. 



Arterial Foramina. Numerous vascular canals are seen in the region of the neck, at 

 the bottom of the trochanteric fossa, in the fossa for the ligamentum teres, on the inter- 

 trochanteric crest, and on the lateral surface of the greater trochanter. The nutrient arteries for 

 the body pierce the bone in a proximal direction on or near the linea aspera. Both the back 

 and the front of the distal end of the body display the openings of numerous vascular canals, 

 and the floor of the intercondyloid fossa is also similarly pierced. 



Connexions. The femur articulates with the hip bone proximally and the tibia and patella 

 distally. The lateral surface of the greater trochanter determines the point of greatest hip width 

 in the male, being covered only by the skin and superficial fascia and the aponeurotic insertion of 

 the glutaeus maximus. In the erect position the tip of the trochanter corresponds to the level of 

 the centre of the hip -joint. When the thigh is flexed the trochanter major sinks under cover 

 of the anterior fibres of the glutseus maximus. In women the hip width is usually greatest at 

 some little distance distal to the trochanter, due to the accumulation of fat in this region. The 

 body of the bone is surrounded on all sides by muscles. Its forward curve, however, is account- 

 able to some extent for the fulness of the front of the thigh. The exposed surfaces of the condyles 

 determine to a large extent the form of the knee. In flexion the articular edges can easily be 

 recognised on either side of and distal to the patella. 



Sexual Differences. According to Dwight, the head of the femur in the female is propor- 

 tionately smaller than that of the male. 



Ossification. The body begins to ossify early in the second month of foetal life, and at 

 birth displays enlargements at both ends, which are capped with cartilage. If at birth the 

 distal cartilaginous end be sliced away, a small ossific nucleus for the distal epiphysis will 

 usually be seen. This, as a rule, makes its appearance towards the latter end of the ninth 



Impression 

 of medial 

 meniscus 



Semilunav facet 

 for medial edge 

 of patella in 

 extreme flexion 



MEDIAL 

 IBIAL SURFACE 



LATERAL 



TIBIAL SURFACE T "_ _, M E DIAL CONDYLE 



Surface of attachment of posterior 

 cruciate ligament 



FIG. 243. DISTAL ASPECT OF DISTAL END OF THE EIGHT FEMUR. 



LATERAL CONDYLE 

 INTERCONDYLOID FOSSA 



