Joints and ligaments · Lower limb
Ligament of the femoral head !
The ligament of the femoral head is a small band inside the hip, from the socket to the ball of the femur; it carries a small artery.
Official name: Ligament of head of femur
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What it is
A small ligament inside the hip joint (ligamentum teres), running from the bottom of the socket to a pit on the ball of the femur.
What it does
Helps steady the hip, especially in deep bending and squatting. It carries a small artery that matters most for the femoral head in children.
Key facts
- Attaches
- Acetabular notch and transverse acetabular ligament to fovea of femoral head
- Function
- Weak stabilizer; carries artery of ligament of head (from obturator), important in children
- Tight in
- Hip flexion with adduction and external rotation
Relations
- Course
- From the acetabular notch and transverse acetabular ligament up through the acetabular fossa to the fovea of the femoral head
- Contents
- Artery of the ligament of the head (acetabular branch of the obturator artery), wrapped in synovium
- Deep
- Acetabular fossa with the pulvinar fat pad, inside the horseshoe-shaped lunate surface
- Below
- Transverse acetabular ligament, under which its artery enters the joint
How to find it
Seen only at arthroscopy or open surgery. In the central compartment, with the leg under traction, it runs from the acetabular fossa and the transverse ligament to the fovea of the femoral head, covered in synovium beside the fat pad (pulvinar).
Examination
- Ligamentum teres test (some texts): with the hip flexed about 70° and the knee bent, the thigh is fully abducted, brought back about 30° and rotated in and out to the end of range; pain at the end of rotation suggests a tear
On imaging
MR arthrography shows it best on coronal images as a band from the fovea down to the notch; tears appear as thinning, irregular fibres or a gap. After a dislocation, CT may show a small avulsed fragment from the fovea inside the joint.
Common problems
- Tears from hip dislocation, twisting injuries or hip instability, causing deep groin pain and catching.
- Fraying with arthritis or hip dysplasia.
How it is diagnosed
MRI or MR arthrogram; often found during hip arthroscopy.
Treatment
- Physical therapy and activity changes.
- Arthroscopic trimming of a torn ligament (debridement).
- Reconstruction with a graft from the patient or a donor, in selected unstable hips.
Clinical notes
- Obstacles to reducing a dysplastic hip include a thick ligamentum teres, the pulvinar, the transverse acetabular ligament, an inturned labrum and the iliopsoas tendon
- Torn in almost every hip dislocation
- Arthroscopy can debride a torn ligament; reconstruction is reserved for selected cases of instability
Anatomical variants
- Its thickness varies widely between people; sometimes only a synovial fold is left, and rarely even that is missing
Related conditions
- Developmental dysplasia of the hip
- Slipped capital femoral epiphysis
- Legg-Calvé-Perthes disease
- Hip dislocation
Test yourself
Think of the answer, then tap the question to see it.
Which artery runs in the ligament of the femoral head, and how much does it matter in adults?
The artery of the ligament of the head (from the obturator artery); it adds little in adults, who depend on the medial circumflex femoral artery.
In whom is the artery of the ligament of the femoral head most important?
In children, for the blood supply of the femoral head.
How can the ligament of the femoral head hinder reduction in developmental dysplasia of the hip?
It becomes long and thick and can block the femoral head from reducing into the socket.
Where does the ligament of the femoral head attach?
From the acetabular notch and transverse acetabular ligament to the fovea of the femoral head.
Educational information, not medical advice. For any symptom, see a health professional.
Its names
- Official Latin (TA2)
- ligamentum capitis femoris TA2 1882
- Official Spanish (DeCS)
- Ligamento redondo del fémur DeCS D000069593
- English (TA2)
- Ligament of head of femur
- Also called
- ligamentum teres of femur · round ligament of femur · ligamentum teres femoris · ligamentum teres
Related
Sources: Terminologia Anatomica (TA2); DeCS; Anatomy, Bony Pelvis and Lower Limb, Fovea Capitis Femoris; Anatomy, Bony Pelvis and Lower Limb, Hip Joint; Anatomy of the Human Body (20th ed.): Coxal Articulation or Hip-joint (Lea & Febiger (Gray's Anatomy, 1918), 1918) · adapted, Public domain.
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Representative model, for educational purposes only.
