Intracapsular fracturesof the femoral neck or hip dislocations tear the
retinacular arteries that supply the proximal fragment; avascular necro-
sis may result.
The femoral triangleis bounded by the inguinal ligament, the sartorius
muscle, and the adductor longus muscle. A femoral pulseis palpable
high within the femoral triangle just inferior to the inguinal ligament.
The femoral vein, lying just medial to the femoral pulse, is a preferred
site for insertion of venous lines.
The anterior cruciate ligamentis a key stabilizer of the knee joint, pre-
venting posterior movement of the femur on the tibial plateau.
The medial meniscus,being more mobile and attached to the medial
collateral ligament, is most likely to be injured. Twisting movements that
combine lateral displacement with lateral rotation pull the medial
meniscus toward the center of the joint where it may be trapped and
crushed by the medial femoral condyle.
The adductor canal,the location of popliteal aneurysms, contains the
femoral artery, femoral vein, and saphenous nerve.
The deep fibular nerveinnervates the muscles of the anterior compart-
ment (dorsiflexors of the foot and pedal digits). The superficial fibular
nerveinnervates the lateral crural compartment (plantar flexors and
everters of the foot). The tibial nerveinnervates the posterior crural
muscles, which plantarflex and invert the foot.
The posterior tibial arterydescends posteriorly to the medial malleolus
where the posterior tibial pulseis normally palpable.
Inversion sprains,the most common ankle injury, involve the lateral
collateral ligaments.
The plantar calcaneonavicular (spring) ligamentsupports the head of
the talus and thereby maintains the longitudinal plantar arch. Laxity of
this ligament results in fallen arches or “flat feet.”
Sensory distribution of the anterior leg:the web space between the
first and second toes is specific for the fibular nerve (L5) (see following
figure).
