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Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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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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