The fascia of the thigh

The broad fascia of the thigh (fascia lata) is thick, tendinous, and on all sides the muscles of the thigh. Proximally, the fascia is attached to the iliac crest, inguinal ligament, pubic symphysis and ischium, at the back it connects with the gluteal fascia, and downwards it continues into the fascia of the leg. In the upper third of the anterior region of the thigh, within the femoral triangle, the broad fascia of the thigh consists of two plates. Its deep plate (lamina profunda), covering the pectineus muscle and the distal part of the iliopsoas muscle in front, is called the iliopectineal fascia (fascia iliopectinea).

The superficial plate of the broad fascia of the thigh (lamina superficialis) in front covers the superficially lying anterior muscles of the thigh (sartorius, rectus, adductor muscles of the thigh), as well as the femoral artery and vein lying on the deep plate of the broad fascia (along the iliopectineal groove). In the superficial plate distal to the inguinal ligament there is an oval subcutaneous ring through which the great saphenous vein of the leg passes, flowing into the femoral vein. The subcutaneous ring (oval fossa, fossa ovalis) is closed by the ethmoid fascia, which has numerous openings for the passage of small vessels and nerves. Laterally, the subcutaneous ring is limited by the falcate edge. The superior horn (cornu superius) of the falcate edge medially wedges between the inguinal ligament above and the ethmoid fascia below. The lower horn (cornu inferius) of the falciform edge, being part of the superficial leaflet of the broad fascia of the thigh, limits the subcutaneous ring from below. The subcutaneous ring is the external (subcutaneous) opening of the femoral canal (see above) in the case of a femoral hernia exiting the pelvic cavity through the femoral canal under the skin of the thigh.

From the broad fascia that envelops the muscles of the thigh, two intermuscular septa extend, forming osteofascial and fascial sheaths for the muscles. The lateral intermuscular septum (septum intermusculare femoris laterale), attached to the lateral lip of the rough line of the femur, separates the posterior group of muscles (biceps femoris) from the anterior group (quadriceps femoris). The medial intermuscular septum (septum intermusculare femoris mediale), attached to the medial lip of the rough line of the femur, separates the quadriceps femoris, located in its anterior region, from the adductor muscles (pectineus, adductor longus, and others). Sometimes in the posteromedial region of the thigh there is a weakly expressed posterior intermuscular septum, separating the adductor group of muscles (the adductor magnus and gracilis muscles) from the semimembranosus and semitendinosus muscles, which belong to the posterior group of the thigh muscles.

The broad fascia, splitting, forms fascial sheaths for the tensor of the broad fascia of the thigh, the sartorius and gracilis muscles. On the lateral side of the thigh, the broad fascia, thickening, forms the so-called iliotibial tract, which is the tendon of the tensor of the broad fascia. The broad fascia continues below onto the knee joint, which covers the front and sides, and even lower it passes into the fascia of the leg. Behind, the broad fascia is thrown over the popliteal fossa and here is called the popliteal fascia.

In the anterior region of the knee, under the skin and under the fascia, there is a series of synovial bursae. Between the layers of the superficial fascia lies the subcutaneous prepatellar bursa (bursa subcutanea prepatellaris). Under the proper fascia is the prepatellar subfascial bursa (bursa subfascial prepatellaris). Slightly below the patella is the subcutaneous bursa of the tibial tuberosity (bursa subcutanea tuberositas tibia), as well as the subcutaneous infrapatellar bursa (bursa subcutanea infrapatellaris).

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