Trauma & OrthopaedicsPending review

Neck of Femur Fracture

The fracture line's relationship to the hip capsule decides whether the femoral head's blood supply survives, which in turn decides whether the head is fixed in place or replaced.

First principles

The fracture line decides the blood supply, and the blood supply decides the surgery

The femoral head is supplied retrogradely by ascending cervical branches of the medial circumflex femoral artery, which run up the femoral neck within the hip capsule before piercing the head. An intracapsular fracture (subcapital or transcervical) shears these vessels as they cross the neck, threatening the head's blood supply. An extracapsular fracture (intertrochanteric or subtrochanteric) lies outside the capsule, so the retinacular vessels are spared and the head keeps its blood supply.

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Educational content pending clinical review. Not medical advice.