The lower limb is anatomically dedicated to load-bearing, balance, and locomotion. This chapter explores how stability is prioritised over mobility, and how structural alignment, muscular power, and neurovascular organisation combine to support standing, walking, and running. It also explains why injury and disease in the lower limb so often disrupt independence and quality of life.
The chapter begins with the osteology of the lower limb, tracing the continuity from pelvis to foot. The femur, tibia, fibula, patella, and bones of the foot are examined as components of a kinetic chain rather than isolated elements. Joint orientation, weight transmission, and alignment are emphasised, providing the anatomical basis for gait efficiency and common degenerative changes.
Attention then turns to the hip joint, presented as a deep, stable ball-and-socket joint designed to bear body weight while permitting controlled movement. The capsule, ligaments, and surrounding musculature are explored in relation to stability, explaining patterns of dislocation, fracture, and referred pain. The blood supply of the femoral head is highlighted for its clinical importance in avascular necrosis.
The thigh compartments are examined next, organised by function and innervation. The anterior, medial, and posterior compartments are explored as coordinated systems rather than muscle lists, reinforcing how nerve injury or vascular compromise produces predictable deficits. The femoral triangle and adductor canal are introduced as key neurovascular corridors with high clinical relevance.
The chapter then focuses on the knee joint, a region of anatomical complexity and clinical vulnerability. Ligaments, menisci, and articulating surfaces are examined in detail, explaining stability, movement, and injury patterns. The anatomical basis of common injuries—ACL tears, meniscal damage, and osteoarthritis—is grounded in joint structure and biomechanics.
Moving distally, the leg compartments are explored with particular attention to fascial boundaries and pressure dynamics. This organisation provides the anatomical foundation for understanding compartment syndrome, vascular compromise, and nerve entrapment. The ankle joint is examined as a stable hinge adapted for weight transfer rather than rotation.
The foot is treated as a structural masterpiece, balancing rigidity for propulsion with flexibility for terrain adaptation. The arches of the foot—medial, lateral, and transverse—are examined as dynamic load-distributing systems, explaining the anatomical basis of flatfoot, high arches, and overuse injuries.
Neurovascular anatomy is integrated throughout. Major nerves—the femoral, obturator, sciatic, tibial, and common fibular nerves—are traced through compartments, reinforcing patterns of sensory loss and motor weakness. Arterial supply and venous drainage are examined in relation to surface landmarks, trauma, and peripheral vascular disease.
Surface anatomy and imaging correlations anchor the chapter clinically. Palpable landmarks, joint lines, and vascular pulses are tied directly to examination and intervention.
By the end of the chapter, the lower limb is understood as a functional pillar—an anatomical system where alignment, integrity, and coordination determine mobility, resilience, and independence.
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