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Anatomy

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Femoral neck fractures are intracapsular and may threaten any or all of the three sources of blood to the femoral head:

  • the cervical vessels in the retinaculum of the joint capsule - usually damaged if the fracture is displaced

  • intramedullary vessels - always torn

  • from the ligamentum teres - usually contributes minimally in the elderly and not uncommonly, may be non-existent

In addition to the damage to the blood supply, the intracapsular nature of the fracture hinders recovery from the injury:

  • intra-articular bone has only a thin periosteum and has no contact with soft tissues - the response to injury - callus formation - is weak

  • blood remains inside the joint capsule, increasing intracapsular pressure and further damaging the femoral head; synovial fluid hinders clotting

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