Zhao P, Jin Z W, Kim J H, Abe H, Murakami G, Rodríguez-Vázquez J F
Department of Anatomy, Wuxi School of Medicine, Jiangnan University, Wuxi, China.
Department of Anatomy, Chonbuk National University Medical School, Jeonju, Republic of Korea.
Folia Morphol (Warsz). 2019;78(2):408-418. doi: 10.5603/FM.a2018.0083. Epub 2018 Sep 4.
Prenatal twisting of the femoral neck seems to result in an angle of anteversion or torsion, but the underlying process has not been elucidated.
This study analysed sagittal, frontal and horizontal sections of 34 embryo and foetal specimens of gestational age (GA) 6-16 weeks (crown-rump length 21-130 mm). At GA 6-7 weeks, the iliopsoas (IP) and gluteus medius (GME) muscles were inserted into the anterior and posterior aspects of the femur, respectively, allowing both insertions to be viewed in a single sagittal section.
At GA 8 weeks, the greater trochanter and the femoral neck angle became evident, and the GME tendon was inserted into the upper tip of the trochanter. At GA 9 weeks, the location of IP insertion was to the medial side of the GME insertion. After 9 weeks, the IP insertion consisted of a wavy, tendino- us part of the psoas muscle and another part of the iliacus muscle, with many fibres of the latter muscle attached to the joint capsule. After GA 12 weeks, the IP was inserted into the anteromedial side of the greater trochanter, while the aponeurotic insertion of the GME wrapped around the trochanter. At GA 15-16 weeks, a deep flexion at the hip joint caused an alteration in the relative heights of the lesser and greater trochanter, with the former migrating from the inferior to the slightly superior side.
These findings indicate that twisting of the femoral neck started at GA 8-9 weeks.
股骨颈产前扭转似乎会导致前倾或扭转角度，但潜在过程尚未阐明。
本研究分析了34例孕龄（GA）6 - 16周（顶臀长21 - 130毫米）胚胎和胎儿标本的矢状面、额状面和水平面切片。在孕龄6 - 7周时，髂腰肌（IP）和臀中肌（GME）分别插入股骨的前侧和后侧，使得在单个矢状面切片中可以看到这两个插入点。
在孕龄8周时，大转子和股骨颈角度变得明显，并且GME肌腱插入大转子的上尖端。在孕龄9周时，IP插入点位于GME插入点的内侧。9周后，IP插入由腰大肌的波浪状腱性部分和髂肌的另一部分组成，后者的许多纤维附着于关节囊。孕龄12周后，IP插入大转子的前内侧，而GME的腱膜插入环绕大转子。在孕龄15 - 16周时，髋关节的深度屈曲导致小转子和大转子相对高度的改变，前者从下方迁移至略上方。
这些发现表明股骨颈扭转始于孕龄8 - 9周。
