Structure
The fascia lata of the thigh is a deep, investing fascia of the thigh. It is described as an elastic stocking, as it surrounds the muscles of the thigh. It is thickened laterally to form a thick band of fascia called the iliotibial tract or iliotibial band (Beals, 2009; Evans, 1979). The tract extends from the iliac crest and the capsule of the hip joint to the lateral condyle of the tibia. It serves as a site of insertion for two muscles, the gluteus maximus and the tensor fascia latae (Stecco et al., 2013). The fascia lata is also thickened at the knee because of additional fibers from the tendons of biceps femoris, quadriceps femoris, and sartorius muscles. It is thin posteromedially over the adductor muscles.
The fascia lata contains an oval opening called the saphenous opening, which lies approximately 4 cm below and lateral to the pubic tubercle. Its long axis is directed downwards and laterally. The opening has lateral and medial margins. The arched lateral margin is called the falciform margin, which lies in front of the femoral sheath. Its proximal and distal extensions are referred to as the superior and inferior horns of the falciform margin. The medial margin of the opening lies at a deeper level and is formed by the fascia overlying the pectineus muscle, which passes behind the femoral sheath. The saphenous opening is plugged in by the cribriform fascia. The opening serves as a gateway for the passage of great saphenous vein and the superficial branches of the femoral artery.
Related parts of the anatomy
Anatomical Relations
Proximally, it is continuous with the membranous layer of the subcutaneous tissue of the lower abdominal wall and is attached to the inguinal ligament, the pubic arch, and pubic tubercle medially. Laterally, it is attached to the iliac crest, and posteriorly to the sacrum, coccyx, ischial tuberosity, and ischiopubic ramus. Distally, it is attached to the femur, tibia, and fibula at the knee and to the deep fascia of the leg (Standring, 2016).
The fascia lata gives rise to medial, lateral, and posterior femoral intermuscular septa that extend all the way to the shaft of the femur. They divide the thigh region into three osteofascial compartments; the anterior, medial, and posterior compartments.
Function
The fascia lata is described as an elastic stocking, as it surrounds the muscles of the thigh under the skin. It limits outward expansion of contracting thigh muscles and aids venous return from the lower extremity. The lateral thickening of the fascia lata, the iliotibial tract, provides stability to the knee joint in extended and partially flexed positions.
List of Clinical Correlates
—Autologous fascial grafts
—Facial reconstruction surgery
References
Beals, R. K. (2009) 'The iliotibial tract: a review', Current Orthopaedic Practice, 20(1), pp. 87-91.
Evans, P. (1979) 'The postural function of the iliotibial tract', Ann R Coll Surg Engl, 61(4), pp. 271-80.
Standring, S. (2016) Gray's Anatomy: The Anatomical Basis of Clinical Practice. Gray's Anatomy Series 41st edn.: Elsevier Limited.
Stecco, A., Gilliar, W., Hill, R., Fullerton, B. and Stecco, C. (2013) 'The anatomical and functional relation between gluteus maximus and fascia lata', J Bodyw Mov Ther, 17(4), pp. 512-7.
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Fascia Lata
The iliotibial band is a portion of the fascia lata of the thigh that extends inferiorly from the sacrum, the iliac crest and the ischium, over the greater trochanter of the femur and lateral aspect of the thigh to insert into the lateral condyle of the femur and tibia.
