The lateral retinacular fibres of the hip capsule run along the lateral femoral neck and carry the ascending cervical blood vessels that supply the femoral head. Their disruption in femoral neck fractures explains the high rate of avascular necrosis — particularly in displaced fractures where the retinacular vessels are torn.
Lateral hip capsular reinforcement at the femoral neck; contributes to retinacular vessel protection; supplements the zona orbicularis in lateral containment.
The lateral retinacular ligament integrity is assessed by the Garden classification of femoral neck fractures — Garden III and IV (displaced) disrupt these fibres and the retinacular vessels, increasing AVN risk. Urgent anatomic reduction within 6-12 hours is recommended to maximise retinacular vessel patency.
Disruption of the lateral retinacular ligament in displaced femoral neck fracture severing the ascending cervical blood vessels producing avascular necrosis risk requiring urgent anatomic reduction.
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