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Purpose <p>The fovea capitis femoris (FCF) is widely used as a surgical and radiological landmark of the femoral head; however, its anatomical relationship with the angular geometry of the proximal femur remains insufficiently defined. Although the fovea is routinely used as a reference point in femoral head procedures, the influence of the femoral inclination angle (FIA) on its morphology and localisation remains insufficiently defined and underappreciated in clinical practice. This study aimed to comprehensively quantify the morphometric and morphological characteristics of the FCF and to investigate their relationship with proximal femoral parameters, with particular emphasis on the FIA.</p> Methods <p>A total of 382 adult dry femurs (75 right, 207 left) were analysed. Femur length (FL), FIA, femoral head area (AHOF), foveal area (AFCF), foveal diameters, depth, shape, and localisation were measured using digital callipers and ImageJ software. Correlation and regression analyses were performed to evaluate relationships among parameters.</p> Results <p>The fovea was most commonly oval or round and was predominantly located in the postero-inferior quadrant of the femoral head. FIA showed a significant positive correlation with both AFCF (r = 0.162, <i>p</i> &lt; 0.001) and the AFCF/AHOF ratio (r = 0.198, <i>p</i> &lt; 0.001), indicating that larger foveae are associated with greater FIA. FL was correlated with AHOF (r = 0.268, <i>p</i> &lt; 0.001), and AHOF was strongly correlated with foveal size (AFCF: r = 0.529, <i>p</i> &lt; 0.001), demonstrating proportional scaling of the fovea with overall femoral size. Regression analysis further showed that AFCF significantly predicted FIA (FIA = 127.2 + 1.68 × AFCF).</p> Conclusion <p>These findings indicate that FCF morphology reflects the global angular and geometric configuration of the proximal femur and support the clinical relevance of incorporating femoral inclination into radiological assessment and surgical procedures that rely on the fovea as a reference point.</p>

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The fovea capitis femoris as a dynamic surgical landmark: morphometric associations with the femoral inclination angle

  • 期刊论文

  • 发表日期：

    2026年3月17日

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  • Fatma Nur Türkoğlu,
  • Duygu Akın Saygın,
  • Şerife Alpa,
  • Anıl Didem Aydın Kabakçı

摘要

Purpose

The fovea capitis femoris (FCF) is widely used as a surgical and radiological landmark of the femoral head; however, its anatomical relationship with the angular geometry of the proximal femur remains insufficiently defined. Although the fovea is routinely used as a reference point in femoral head procedures, the influence of the femoral inclination angle (FIA) on its morphology and localisation remains insufficiently defined and underappreciated in clinical practice. This study aimed to comprehensively quantify the morphometric and morphological characteristics of the FCF and to investigate their relationship with proximal femoral parameters, with particular emphasis on the FIA.

Methods

A total of 382 adult dry femurs (75 right, 207 left) were analysed. Femur length (FL), FIA, femoral head area (AHOF), foveal area (AFCF), foveal diameters, depth, shape, and localisation were measured using digital callipers and ImageJ software. Correlation and regression analyses were performed to evaluate relationships among parameters.

Results

The fovea was most commonly oval or round and was predominantly located in the postero-inferior quadrant of the femoral head. FIA showed a significant positive correlation with both AFCF (r = 0.162, p < 0.001) and the AFCF/AHOF ratio (r = 0.198, p < 0.001), indicating that larger foveae are associated with greater FIA. FL was correlated with AHOF (r = 0.268, p < 0.001), and AHOF was strongly correlated with foveal size (AFCF: r = 0.529, p < 0.001), demonstrating proportional scaling of the fovea with overall femoral size. Regression analysis further showed that AFCF significantly predicted FIA (FIA = 127.2 + 1.68 × AFCF).

Conclusion

These findings indicate that FCF morphology reflects the global angular and geometric configuration of the proximal femur and support the clinical relevance of incorporating femoral inclination into radiological assessment and surgical procedures that rely on the fovea as a reference point.