Evaluation of the Effects of Fovea Capitis Femoris Localization and Morphometry on the Femoral Head

Hilal Gören; Nilgün Tuncel Çini; Yüksel Aydar

doi:10.35440/hutfd.1682803

Research Article

Fovea Capitis Femoris Lokalizasyonun ve Morfometrisinin Femur Başı Üzerine Olan Etkilerinin Değerlendirilmesi

Year 2025, Volume: 22 Issue: 2, 344 - 350

Hilal Gören , Nilgün Tuncel Çini , Yüksel Aydar

https://doi.org/10.35440/hutfd.1682803

Abstract

Amaç: Fovea capitis femoris (FCF), femur başı üzerinde yer alan belirgin bir çöküntü olup, ligamentum capitis femoris’in distal tutunma noktasını oluşturmaktadır ve aynı zamanda vasküler yapıların girişine olanak tanıyan bir geçit işlevi görebilmektedir. FCF’nin anatomik varyasyonları, kalça ekleminin biyomekanik özelliklerini etkileyebileceği gibi avasküler nekroz ve dejeneratif hastalıklar gibi patolojik durumların gelişiminde de rol oynayabilir. Bu çalışmanın amacı, FCF’nin morfometrik özelliklerini ve kadran temelli lokalizasyonunu analiz etmek ve bu parametrelerin femur başı geometrisi ile olan ilişkisini değerlendirmektir.
Materyal ve Metod: Çalışmada yetmiş bir erişkin kuru femur incelenmiştir. Femur başlarının standardize medi-olateral görüntüleri elde edilmiştir. Transvers ve longitudinal çaplar, derinlik, alan ve çevre gibi morfometrik parametreler dijital kumpas ve ImageJ yazılımı kullanılarak ölçülmüştür. Ayrıca femur başının yüzey alanı ve çevre uzunluğu da kaydedilmiştir. FCF’nin lokalizasyonu, kadran temelli bir model kullanılarak sınıflandırılmıştır. Elde edilen veriler, ANOVA ve Hochberg’in GT2 post-hoc testi ile istatistiksel olarak analiz edilmiştir.
Bulgular: FCF konfigürasyonları arasında en sık gözlenen tip Tip II olup, olguların %64,8’ini oluşturmaktadır. Tip I, III ve V konfigürasyonları ise her biri %7,0 oranında tespit edilmiştir. En yüksek ortalama alan ve çevre değerleri Tip V’de, en düşük değerler ise Tip I’de saptanmıştır. Longitudinal uzunluk (p = 0,005), alan (p = 0,001) ve çevre (p = 0,001) değişkenleri açısından gruplar arasında istatistiksel olarak anlamlı fark bulunmuştur. Tip I konfigürasyonunun daha kompakt morfolojik bir yapıya sahip olması, ligamentöz tutunma alanının ve vasküler girişin daha sınırlı olabileceğini düşündürmektedir.
Sonuç: FCF’nin morfolojik yapısı, tipolojik sınıflamasına bağlı olarak anlamlı varyasyonlar göstermektedir. Bu varyasyonlar, ligamentum capitis femoris’in tutunma potansiyelini ve femur başının vaskülarizasyonunu etki-leyebilir. Söz konusu morfometrik farklılıkların cerrahi planlamada ve radyolojik değerlendirmelerde dikkate alınması, özellikle femur başını içeren girişimlerde komplikasyonların azaltılmasına katkı sağlayabilir.

Keywords

Femur, Femur başı, Fovea capitis femoris, Kalça eklemi, Ligamentum capitis femoris

References

1. Cerezal L, Kassarjian A, Canga A, Dobado MC, Montero JA, Llopis E, et al. Anatomy, biomechanics, imaging, and man-agement of ligamentum teres injuries. Radiographics. 2010;30(6):1637-51. doi: 10.1148/rg.306105516.
2. Michaels G, Matles AL. The role of the ligamentum teres in congenital dislocation of the hip. Clin Orthop. 1970;71:199-201.
3. Standring S, Borley NR. Gray’s anatomy: The anatomical basis of clinical practice. London: Churchill Livingstone; 2008:1360-90.
4. Beltran LS, Mayo JD, Rosenberg ZS, De Tuesta MD, Martin O, Neto LP, et al. Fovea alta on MR images: is it a marker of hip dysplasia in young adults? AJR Am J Roentgenol. 2012;199:879-83. doi: 10.2214/AJR.11.8193.
5. Bensler S, Agten CA, Pfirrmann CWA, Sutter R. Osseous spurs at the fovea capitis femoris—a frequent finding in asympto-matic volunteers. Skeletal Radiol. 2018;47(1):69-77. doi: 10.1007/s00256-017-2763-x.
6. Nötzli H, Müller S, Ganz R. Die radiologische Beziehung der Fovea capitis femoris zur azetabulären Belastungszone bei der normalen und dysplastischen Hüfte des Erwachsenen. Z Orthop Ihre Grenzgeb. 2001;319:502-6. doi: 10.1055/s-2001-19231.
7. Chung S. The arterial supply of the developing proximal end of the human femur. J Bone Joint Surg Am. 1976;58:961-70.
8. Perumal V, Woodley SJ, Nicholson HD. The morphology and morphometry of the fovea capitis femoris. Surg Radiol Anat. 2017;39(7):791-8. doi: 10.1007/s00276-016-1810-y.
9. Sampatchalit S, Barbosa D, Gentili A, Haghighi P, Trudell D, Resnick D. Degenerative changes in the ligamentum teres of the hip: cadaveric study with magnetic resonance arthrogra-phy, anatomical inspection, and histologic examination. J Comput Assist Tomogr. 2009;33(6):927-33. doi: 10.1097/RCT.0b013e318199d89e.
10. Albanese J, Eklics G, Tuck A. A metric method for sex deter-mination using the proximal femur and fragmentary hip-bone. J Forensic Sci. 2008;53:1283-8. doi: 10.1111/j.1556-4029.2008.00855.x.
11. Kurylo JC, Templeman D, Mirick GE. The perfect reduction: approaches and techniques. Injury. 2015;46(3):441-4. doi: 10.1016/j.injury.2014.11.027.
12. Yarar B, Malas MA, Çizmeci G. The morphometry, localiza-tion, and shape types of the fovea capitis femoris, and their relationship with the femoral head parameters. Surg Radiol Anat. 2020;42(10):1243-54. doi: 10.1007/s00276-020-02508-5.
13. Ceynowa M, Roclawski M, Pankowski R, Mazurek T. The position and morphometry of the fovea capitis femoris in computed tomography of the hip. Surg Radiol Anat. 2019;41(1):101-7. doi: 10.1007/s00276-018-2097-y.
14. Golpınar M. Morphometric and morphological evaluation of the fovea capitis femoris. Med Records. 2022;4(3):400-4. doi.org/10.37990/medr.1107706
15. Zhao KY, Zhang FF, Quan K, Zhu B, Li GY, Mei J. Insufficient blood supply of fovea capitis femoris, a risk factor of femoral head osteonecrosis. J Orthop Surg Res. 2021;16(1):414. doi: 10.1186/s13018-021-02564-6.
16. Singh R, Yadav N. Morphometry and morphology of the fovea capitis of the femoral head and its associated implications. Cureus. 2025;17(3):e79992. doi: 10.7759/cureus.79992.
17. Orupabo CD, Oghenemavwe LE, Didia BC. Sex and age esti-mation using the morphometric assessment of the femur. Sch Int J Anat Physiol. 2023;6(4):42-8. doi: 10.36348/sijap.2023.v06i04.002.

Evaluation of the Effects of Fovea Capitis Femoris Localization and Morphometry on the Femoral Head

Year 2025, Volume: 22 Issue: 2, 344 - 350

Hilal Gören , Nilgün Tuncel Çini , Yüksel Aydar

https://doi.org/10.35440/hutfd.1682803

Abstract

Background: The fovea capitis femoris (FCF) is a distinct depression on the femoral head, serving as the inser-tion point for the ligamentum capitis femoris and potentially allowing vascular entry. Avascular necrosis and degenerative illnesses, as well as hip biomechanics, may be impacted by anatomical differences of the FCF. This study aimed to analyze the morphometric features and quadrant-based localization of the FCF and assess their relationships with femoral head geometry.
Materials and Methods: Seventy-one adult dry femurs were examined. The mediolateral images were standar-dized.
Morphometric parameters—including transverse and longitudinal diameters, depth, area, and perimeter—were measured using a digital caliper and ImageJ. Femoral head surface area and perimeter were also record-ed. The location of the FCF was determined using a quadrant-based model. Statistical analysis involved ANOVA and Hochberg’s GT2 for post-hoc test.
Results: Type II was the most common FCF configuration (64.8%), while Type I, III, and V were each found in 7.0% of cases. Type V showed the highest area and perimeter values, whereas Type I had the lowest. Signifi-cant differences were observed among types for longitudinal length (p = 0.005), area (p = 0.001), and perime-ter (p = 0.001). Type I exhibited a significantly more compact profile, possibly indicating reduced ligament attachment and vascular ingress.
Conclusions: FCF morphology varies according to its structural type and may influence both ligamentous an-chorage and vascular supply. Understanding these variations may aid in surgical planning and radiological assessment, particularly in procedures involving the femoral head.

Keywords

Femur, Femur head, Fovea capitis femoris, Hip joint, Ligamentum capitis femoris

Ethical Statement

The authors affirm that the study was conducted in accordance with the ethical principles outlined in the 1964 Declaration of Helsinki and its subsequent revisions. As the research did not involve living human participants, animal experimentation, or identifiable personal data, and the bones used were derived from cadaveric donations officially registered with the Department of Anatomy, no separate approval from an ethics committee was required

Thanks

We thank all the individuals who have donated their bodies as cadavers because of their belief in science.

References

1. Cerezal L, Kassarjian A, Canga A, Dobado MC, Montero JA, Llopis E, et al. Anatomy, biomechanics, imaging, and man-agement of ligamentum teres injuries. Radiographics. 2010;30(6):1637-51. doi: 10.1148/rg.306105516.
2. Michaels G, Matles AL. The role of the ligamentum teres in congenital dislocation of the hip. Clin Orthop. 1970;71:199-201.
3. Standring S, Borley NR. Gray’s anatomy: The anatomical basis of clinical practice. London: Churchill Livingstone; 2008:1360-90.
4. Beltran LS, Mayo JD, Rosenberg ZS, De Tuesta MD, Martin O, Neto LP, et al. Fovea alta on MR images: is it a marker of hip dysplasia in young adults? AJR Am J Roentgenol. 2012;199:879-83. doi: 10.2214/AJR.11.8193.
5. Bensler S, Agten CA, Pfirrmann CWA, Sutter R. Osseous spurs at the fovea capitis femoris—a frequent finding in asympto-matic volunteers. Skeletal Radiol. 2018;47(1):69-77. doi: 10.1007/s00256-017-2763-x.
6. Nötzli H, Müller S, Ganz R. Die radiologische Beziehung der Fovea capitis femoris zur azetabulären Belastungszone bei der normalen und dysplastischen Hüfte des Erwachsenen. Z Orthop Ihre Grenzgeb. 2001;319:502-6. doi: 10.1055/s-2001-19231.
7. Chung S. The arterial supply of the developing proximal end of the human femur. J Bone Joint Surg Am. 1976;58:961-70.
8. Perumal V, Woodley SJ, Nicholson HD. The morphology and morphometry of the fovea capitis femoris. Surg Radiol Anat. 2017;39(7):791-8. doi: 10.1007/s00276-016-1810-y.
9. Sampatchalit S, Barbosa D, Gentili A, Haghighi P, Trudell D, Resnick D. Degenerative changes in the ligamentum teres of the hip: cadaveric study with magnetic resonance arthrogra-phy, anatomical inspection, and histologic examination. J Comput Assist Tomogr. 2009;33(6):927-33. doi: 10.1097/RCT.0b013e318199d89e.
10. Albanese J, Eklics G, Tuck A. A metric method for sex deter-mination using the proximal femur and fragmentary hip-bone. J Forensic Sci. 2008;53:1283-8. doi: 10.1111/j.1556-4029.2008.00855.x.
11. Kurylo JC, Templeman D, Mirick GE. The perfect reduction: approaches and techniques. Injury. 2015;46(3):441-4. doi: 10.1016/j.injury.2014.11.027.
12. Yarar B, Malas MA, Çizmeci G. The morphometry, localiza-tion, and shape types of the fovea capitis femoris, and their relationship with the femoral head parameters. Surg Radiol Anat. 2020;42(10):1243-54. doi: 10.1007/s00276-020-02508-5.
13. Ceynowa M, Roclawski M, Pankowski R, Mazurek T. The position and morphometry of the fovea capitis femoris in computed tomography of the hip. Surg Radiol Anat. 2019;41(1):101-7. doi: 10.1007/s00276-018-2097-y.
14. Golpınar M. Morphometric and morphological evaluation of the fovea capitis femoris. Med Records. 2022;4(3):400-4. doi.org/10.37990/medr.1107706
15. Zhao KY, Zhang FF, Quan K, Zhu B, Li GY, Mei J. Insufficient blood supply of fovea capitis femoris, a risk factor of femoral head osteonecrosis. J Orthop Surg Res. 2021;16(1):414. doi: 10.1186/s13018-021-02564-6.
16. Singh R, Yadav N. Morphometry and morphology of the fovea capitis of the femoral head and its associated implications. Cureus. 2025;17(3):e79992. doi: 10.7759/cureus.79992.
17. Orupabo CD, Oghenemavwe LE, Didia BC. Sex and age esti-mation using the morphometric assessment of the femur. Sch Int J Anat Physiol. 2023;6(4):42-8. doi: 10.36348/sijap.2023.v06i04.002.

There are 17 citations in total.

Details

Primary Language	English
Subjects	Orthopaedics
Journal Section	Research Article
Authors	Hilal Gören 0000-0002-3408-0155 Nilgün Tuncel Çini 0000-0003-1412-2634 Yüksel Aydar 0000-0002-0285-9914
Early Pub Date	June 11, 2025
Publication Date
Submission Date	April 24, 2025
Acceptance Date	June 4, 2025
Published in Issue	Year 2025 Volume: 22 Issue: 2

Cite

Vancouver	Gören H, Tuncel Çini N, Aydar Y. Evaluation of the Effects of Fovea Capitis Femoris Localization and Morphometry on the Femoral Head. Harran Üniversitesi Tıp Fakültesi Dergisi. 2025;22(2):344-50.