Copyright 2009
Matthew Diltz MD
Definition
The femoral head is the most proximal portion of the femur.It has a spherical shape for articulation with the acetabulum. It is the ball of the ball and socket joint.
Its unique structural features include articular cartilage. There is a ovoid depression posterior and inferior to the center of the head known as the fovea. The ligamentum teres attachs to the femoral head at the fovea. The ligamentum teres transmits an arterial branch of the posterior division of the obturator artery to the femoral head. This becomes an important blood supply when there is a disruption of the normal vascular supply in a fracture of the femoral neck.
The function of the femoral head is to allow articulation at the hip joint. The femoral head forms the conduit for transforing forces from the axial skeleton to the appendicular skeleton.
Common pathologies specific to the femoral head includes avascular necrosis and slipped capital femoral epiphysis. Avascular necorsis results from the loss of blood supply to the head of the femur. The lack of nutrients leads to bone death and eventual collapse of the cartilage and subchondral bone. Slipped capital femoral epiphysis is a fracture through the physis of the femoral head. Most commonly it occurs as a stress fracture in which repetitive loads lead to a fracture. The proximal head remains located in the acetabulum as the femoral neck and femur are displaced superior and lateral.
Commonly used diagnostic procedures include clinical history and exam. Imaging procedures include plain films and MRI.