The retinacular fibres of the hip are reflections of the hip joint capsule onto the femoral neck, forming longitudinal bands (retinacula of Weitbrecht) that carry the retinacular blood vessels supplying the femoral head. They run along the superior (posterosuperior), inferior, and anterior femoral neck from the capsular attachment toward the head-neck junction. The posterosuperior retinaculum carries the dominant supply to the head in adults.
| Origin | Femoral attachment of the hip joint capsule at the base of the femoral neck |
|---|---|
| Insertion | Femoral neck close to the head-neck junction |
Carry the retinacular blood vessels, mainly the posterosuperior (lateral epiphyseal) branches of the medial circumflex femoral artery, to the femoral head; provide minor secondary capsular stability.
The hip retinacular fibres are the conduit for the critical blood supply to the femoral head. Displaced intracapsular femoral neck fractures disrupt the retinacular vessels, causing avascular necrosis of the femoral head in roughly 15-30% of cases. Prompt anatomical reduction and fixation aims to preserve or restore retinacular flow, though it cannot eliminate the risk. Posterior hip dislocation can stretch or tear the posterior retinaculum. The posterosuperior retinaculum carries the main supply and must be protected during femoral neck reduction and hip preservation surgery.
Tearing of the femoral neck retinacular fibres in displaced intracapsular hip fractures interrupting medial circumflex femoral artery supply to the femoral head, producing avascular necrosis in 15-30% of cases.
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