The femoral neck (femur neck or neck of the femur) is a flattened pyramidal process of
bone
A bone is a Stiffness, rigid Organ (biology), organ that constitutes part of the skeleton in most vertebrate animals. Bones protect the various other organs of the body, produce red blood cell, red and white blood cells, store minerals, provid ...
, connecting the
femoral head
The femoral head (femur head or head of the femur) is the highest part of the thigh bone (femur). It is supported by the femoral neck.
Structure
The head is globular and forms rather more than a hemisphere, is directed upward, medialward, and a l ...
with the
femoral shaft, and forming with the latter a wide angle opening medialward.
Structure
The neck is flattened from before backward, contracted in the middle, and broader laterally than medially.
The vertical diameter of the lateral half is increased by the obliquity of the lower edge, which slopes downward to join the body at the level of the
lesser trochanter
The lesser trochanter is a conical posteromedial bony projection of the femoral shaft. it serves as the principal insertion site of the iliopsoas muscle.
Structure
The lesser trochanter is a conical posteromedial projection of the shaft of the fe ...
, so that it measures one-third more than the antero-posterior diameter.
The medial half is smaller and of a more circular shape.
The anterior surface of the neck is perforated by numerous vascular
.
Along the upper part of the line of junction of the anterior surface with the head is a shallow groove, best marked in
elderly subjects; this groove lodges the orbicular fibers of the capsule of the
hip joint
In vertebrate anatomy, hip (or "coxa"Latin ''coxa'' was used by Celsus in the sense "hip", but by Pliny the Elder in the sense "hip bone" (Diab, p 77) in medical terminology) refers to either an anatomical region or a joint.
The hip region is ...
.
The posterior surface is smooth, and is broader and more concave than the anterior: the posterior part of the
capsule of the hip-joint is attached to it about 1 cm above the
intertrochanteric crest
The intertrochanteric crest is a prominent bony ridge upon the posterior surface of the femur at the junction of the neck and the shaft of the femur. It extends between the greater trochanter superiorly, and the lesser trochanter inferiorly.
Ana ...
.
The superior border is short and thick, and ends laterally at the
greater trochanter
The greater trochanter of the femur is a large, irregular, quadrilateral eminence and a part of the skeletal system.
It is directed lateral and medially and slightly posterior. In the adult it is about 2–4 cm lower than the femoral head.Stan ...
; its surface is perforated by large foramina.
The inferior border, long and narrow, curves a little backward, to end at the lesser trochanter.
Angle of inclination
The angle is widest in infancy, and becomes lessened during growth, so that at
puberty
Puberty is the process of physical changes through which a child's body matures into an adult body capable of sexual reproduction. It is initiated by hormonal signals from the brain to the gonads: the ovaries in a girl, the testes in a boy. ...
it forms a gentle curve from the axis of the body of the bone. In the adult, the neck forms an angle of about 125° with the body, but this varies in inverse proportion to the development of the
pelvis
The pelvis (plural pelves or pelvises) is the lower part of the trunk, between the abdomen and the thighs (sometimes also called pelvic region), together with its embedded skeleton (sometimes also called bony pelvis, or pelvic skeleton).
The ...
and the stature. The angle decreases during the period of growth, but after full growth has been attained it does not usually undergo any change, even in old age; it varies considerably in different persons of the same age.
Coxa vara
Coxa vara is a deformity of the hip, whereby the angle between the head and the shaft of the femur is reduced to less than 120 degrees. This results in the leg being shortened and the development of a limp. It may be congenital and is commonly cau ...
is a
deformity
A deformity, dysmorphism, or dysmorphic feature is a major abnormality of an organism that makes a part of the body appear or function differently than how it is supposed to.
Causes
Deformity can be caused by a variety of factors:
* Arthritis a ...
of the
hip
In vertebrate anatomy, hip (or "coxa"Latin ''coxa'' was used by Celsus in the sense "hip", but by Pliny the Elder in the sense "hip bone" (Diab, p 77) in medical terminology) refers to either an anatomical region or a joint.
The hip region is ...
, whereby the angle between the head and the shaft of the
femur
The femur (; ), or thigh bone, is the proximal bone of the hindlimb in tetrapod vertebrates. The head of the femur articulates with the acetabulum in the pelvic bone forming the hip joint, while the distal part of the femur articulates with ...
is reduced to less than 120 degrees. Its opposite is
coxa valga
Coxa valga is a deformity of the hip where the angle formed between the head and neck of the femur and its shaft is increased, usually above 135 degrees.
The differential diagnosis includes neuromuscular disorders (i.e. cerebral palsy, spinal dy ...
.
![FemurAngles](https://upload.wikimedia.org/wikipedia/commons/3/34/FemurAngles.jpg)
In the
female
Female (Venus symbol, symbol: ♀) is the sex of an organism that produces the large non-motile ovum, ova (egg cells), the type of gamete (sex cell) that fuses with the Sperm, male gamete during sexual reproduction.
A female has larger gamet ...
, in consequence of the increased width of the pelvis, the neck of the femur forms more nearly a right angle with the body than it does in the
male
Male (symbol: ♂) is the sex of an organism that produces the gamete (sex cell) known as sperm, which fuses with the larger female gamete, or ovum, in the process of fertilization.
A male organism cannot reproduce sexually without access to ...
.
It is smaller in short than in long bones, and when the pelvis is wide.
In addition to projecting upward and medialward from the body of the femur, the neck also projects somewhat forward; the amount of this forward projection is extremely variable, but on an average is from 12° to 14°.
Fracture
![Hip fracture classification](https://upload.wikimedia.org/wikipedia/commons/b/ba/Hip_fracture_classification.png)
A fracture of the femoral neck is classified as a type of
hip fracture
A hip fracture is a break that occurs in the upper part of the femur (thigh bone). Symptoms may include pain around the hip, particularly with movement, and shortening of the leg. Usually the person cannot walk.
They most often occur as a res ...
. It is often due to
osteoporosis
Osteoporosis is a systemic skeletal disorder characterized by low bone mass, micro-architectural deterioration of bone tissue leading to bone fragility, and consequent increase in fracture risk. It is the most common reason for a broken bone ...
; in the vast majority of cases, a hip fracture is a
fragility fracture
A pathologic fracture is a bone fracture caused by weakness of the bone structure that leads to decrease mechanical resistance to normal mechanical loads. This process is most commonly due to osteoporosis, but may also be due to other pathologie ...
due to a fall or minor trauma in someone with weakened
osteoporotic
Osteoporosis is a systemic skeletal disorder characterized by low bone mass, micro-architectural deterioration of bone tissue leading to bone fragility, and consequent increase in fracture risk. It is the most common reason for a broken bone am ...
bone. Most hip fractures in people with normal bone are the result of high-energy trauma such as
car accidents, falling from heights, or sports injuries.
For low-grade fractures (Garden types 1 and 2), standard treatment is fixation of the fracture in situ with screws or a sliding screw/plate device. In elderly patients with displaced or intracapsular fractures many surgeons prefer to undertake a
hemiarthroplasty
Hip replacement is a surgical procedure in which the hip joint is replaced by a prosthetic implant, that is, a hip prosthesis. Hip replacement surgery can be performed as a total replacement or a hemi (half) replacement. Such joint replacement or ...
, replacing the broken part of the bone with a metal implant. In elderly patients who are medically well and still active, a
total hip replacement
Hip replacement is a surgical procedure in which the hip joint is replaced by a prosthetic implant, that is, a hip prosthesis. Hip replacement surgery can be performed as a total replacement or a hemi (half) replacement. Such joint replacement ...
may be indicated.
Additional images
File:Slide2DAD.JPG, Hip joint. Lateral view. Femoral neck
File:Slide16DEN.JPG, Femoral neck. Posterior view.
References
External links
*
{{Authority control
Bones of the lower limb
Femur