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Anatomy Atlases: Illustrated Encyclopedia of Human Anatomic Variation: Opus V: Skeletal System: Femur and Patella

Illustrated Encyclopedia of Human Anatomic Variation: Opus V: Skeletal Systems: Thigh

Femur and Patella

Ronald A. Bergman, PhD
Adel K. Afifi, MD, MS
Ryosuke Miyauchi, MD

Peer Review Status: Internally Peer Reviewed

The shaft of the femur has been reported congenitally absent bilaterally, and the unilateral absence of the entire femur has also been described.

Occasionally, the gluteal tuberosity is significantly enlarged and is termed the third trochanter. The gluteal tuberosity may also be absent and, instead, the area may be a hypotrochanteric fossa. In some cases the tuberosity and the fossa coexist.

The development of the linea aspera may also show considerable variation.

A bony process, about 3 cm in length, has been described arising at the origin of the short head of the biceps femoris. It is though by some to be analogous to the supracondylar process of the humerus.

The patella is sometimes bipartite, probably due to failure of the ossification centers to unite, with the proximal lateral corner most frequently found as a separate piece. Congenital absence of the patella has been reported. In cases of congenital absence of the quadriceps muscle, the patella may be present but is usually dislocated.

Congenital Absence of the Femora.

Medial Supracondylar Process of Femur.

Medial Supercondylar Process of Femur.

Variations in Shapes of Patella Partita.


Adams, J.D. and D.R. Leonard. (1925) A development anomaly of the patella frequently diagnosed as fracture. Surg., Gynecol. Obstet. 41:601-604.

Brücki, H. von. (1942) Über die Patella cubiti, eine seltene Abweichung des Ellenbogenskelettes. Z. Orthop. 73:158-160.

Brunner, G. (1891) Über Genese, congenitalen Mangel und rudimentäre Bildung der Patella. Arch. Pathol. Anat. Physiol. Klin. Med. 124:358-373.

Burguières, -. (1837) Absence congéniale du col du femur. Bulletins et Memoires de la Société Anatomique de Paris XII(8)(1837):226-227.

Dide, M. (18 93) Note sur une apophyse anormale recontrée sur un fémur humain. Bull. de la Soc. d'Anthrop. de Paris 4:162-165.

Duhem, -. (1925) Malformations osseuses multiple avec fémur bifide. Bull. et Mém. de la Soc. d'Anthrop. de Paris 6:9-10.

Frantz, C.H. and R. O'Rahilly. (1961) Congenital skeletal limb deficencies. J. Bone Joint Surg. (Am.) 43:1202-1224.

Gasco, J., Del Pino, J.M. and F. Gomar-Sancho. (1987) Double patella: A case of duplication in the coronal plane. J. Bone Joint Surg. (Brit) 69:602-603.

Giles, R.G. (1928) A congenital anomaly of the patella. Texas State J. Med. 23:731-732.

Grashey, R. (1937) Dorsale supracondyläre Femurexostose. Roentgenpraxis 9:278-280.

Greeley, P.W. (1932) Multiple ossification centers of the patella. Am. J. Surg. 18:456-459.

Gruber, W. (1883) In Bildungsanomalien mit Bildungshemmung begründete Bipartition beider Patellae eines jungen Subjects. Arch. Pathol. Anat. Physiol. Klin Med. 94:358-361.

Henkel, L. and H.G. Willert. (1969) Dymelia. A classification and a pattern of malformation in a group of congenital defects of the limbs. J. Bone Joint Surg. (Br.) 51:399-414.

Hyrtl, -. (1858) Ein Fall von Processus supracondyloidens femoris (Gruber) an Lebenden. Sitzungsberichte der Wiener Akad. der Wissen. Math. -Natur. Kl. 31:231-234.

Jones, H.C. and D.W. Hedrick. (1942) Patellar anomalies, roentgenologic and clinical consideration. Radiology 38:30-34.

Jovanin, T., Dupont, J.Y., Halimi, P. and J.P. Lassau. (1982) The synovial folds of the knee joint: An anatomical study. Anat. Clin. 4:47-53.

Katdare, S.S. (1945) Congenital absence of the shaft of the femur on both sides. Indian Med. Gaz. 80:297-298.

Kate, B.R. (1964) A study of the regional variation of the Indian femur - the diameter of the head - its medico legal and surgical application. J. Anat. Soc. India 13:80-84.

Kempson, F.C. (1902) Emargination of the patella. J. Anat. Physiol. 36:419-420.

Kiil-Nielsen, K. (1944) Case of congenital absence of the patella and its treatment. Acta Orthop. Scandianav. 15:49-57.

Kutz, E.R. (1949). Congenital absence of the patellae. J. Pediatr. 34:760-762.

Langston, H.H. (1939-40) Congenital defect of the shaft of the femur. Brit. J. Surg. 27:162-165.

Manohar, K. (1939-40) Congenital absence of the right femur. Brit. J. Surg. 27:158-161.

Manouvrier, L. (1893) Etude sur les variations morphologiques du corps du fémur dans lespèce humaine. Bull. de la Soc. d'Anthrop. de Paris 4:111-144.

Nadgir, Y. G. (1917) The supracondyloid tubercles of the femur. J. Anat. 51:375.

Oetteking, B. (1923) Anomalous patellae. Anat. Rec. 23:269-279.

Pires de Lima, J.A. (1913) On a bone found in the musculus vastus externus of the thigh. J. Anat. Physiol. 47:414-424.

Pittard, E., Manula, L. and A. Manula. (1946) Troisème trochanter et fosse hypotrochantérienne chez 500 fémurs humains (250 de chaque sexe) provenant de la région de Genève. Caractères fonctionnels ou caractéres réversifs? Actes Soc. Helvétiques Sci. Nat. 1946:175-176. Cited in Excerpta Medica, Sec. 1, Vol. 2, abstract 1372, p. 484, 1948.

Roudenko, M.S. (1914) Note sur les variations de l'inclinasion de la tête du fémur et sur la hauteur ischio-suscotyloideinne suivant l'indice bustoskelique. Bull. et Mém. de la Soc. d'Anthropol. de Paris 5:200-204.

Senturia, H.R. and B.D. Senturia. (1944) Congenital absence of the patellae associated with arthrodysplasia of the elbows and dystrophy of the nails. A hereditary syndrome. Am. J. Roentgenol. 51:352-358.

Shah, M.A. (1945) The popliteal facet in men who habitually squat. Nature 156:237-238.

Siddiqi, M.A.H. (1933-34) Variations in the lower end of the femur from Indians. J. Anat. 68:331-337.

Siddiqi, M.A.H. ((1935-36) Observations on the lower end of the femur from American Indians and modern Canadians. J. Anat. 70:410-412.

De Souza Fontes, J.R. (1877) Ein Lebender Knabe mit angeborenem Mangel der Glieder. Arch. Pathol. Anat. Physiol. Klin. Med. 71:107-111.

Stoppord, J.S.B. (1915) The supracondyloid tubercles of the femur and the attachment of the gastronemius muscle to the femoral diaphysis. J. Anat. Physiol. 49:80-84.

Sunderland, S. (1938) The quadrate tubercle of the femur. J. Anat. 72:309-312.

Susman, M.P. (1934) Rudimentary patellae, other skeletal defects, and dystrophy of the nails. Med. J. Australia 1:685-686.

Swaton, S. and Z. Huber. (1960) Einseitige, angeborene, doppelte Kniescheibe (Patella duplex unilateralis congenital). Zentralbl. Chir. 85:2270-2274.

Todd, T.W. and W.C. McCally. (1921) Defects of the patellar border. Ann. Surg. 74:775-782.

Treves, F. (1887) A gluteal trochanter in the human subject. J. Anat. Physiol. 21:325-327.

Williams, W.R. (1884) Congenital absence of the femora. Trans. Path. Soc. Lond. 35:317-318.

Wright, W. (1904) Case of accessory patellae in the human subject, with remarks on emargination of the patella. J. Anat. Physiol. 38:65-67.

Wütschke, J. (1953) Ein Fall von linksseitiger doppeler Patella. Fortschr. Röntgenstr. 78:218-220.

Wütschke, (1966) J. Patella partita und Patella duplex (kritische Betrachtung zur Differentialdiagnose). Fortschr. Roentgenstr. 104:260-263.

Zammit, J. (1898) Posterior dichotomy: A three-legged boy. Brit. Med. J. 1:1528

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