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Fracture Around Hip

  1. Blood Supply
    Most important blood supply of femoral head in adults is ascending cervical or retinacular vessels.
  2. Blood Supply of Proximal Femur (Head & Neck)
    Crock divide it into 3 major groups
    1. Artery of Ligamentum teres
      1. is a branch of obturator artery
      2. also called as Medial Epiphyseal artery
    2. Arterial Rings & Retinacular Vessels
      1. Extra Capsular Arterial Ring
        i. Formed anteriorly by lateral circumflex femoral artery (br of profunds femoris art)
        ii. Formed laterally, posteriorly & medially by medial circumflex femoral artery (branch of profunda femoris artery)
  3. Ascending Cervial/ Retinacular vessels
    1. Arise from entracapsular arterial ring in anterior, posterior, medial & lat groups
    2. Lateral gp is most imp. as it supplies 2/3rd head including weight bearing supero lateral portion.
  4. ​Chung Subsynovial arterial ring 
    1. These ascending branches form arterial Ring at sub capital region
    2. It is a partial ring
Description: Description: http://img.medscape.com/pi/emed/ckb/sports_medicine/84611-86659-199.jpg
  1. Epiphyseal Arteries
    1. Arise from subsynovial arterial ring
    2. Lateral epiphyseal artery are most important as it supplies weight bearing portion
  2. Intraosseous Blood Supply
Age Wise Blood Supply of Neck Femur


Blood Supply

<4 yr =

Metaphyseal Artery

Retinecular Arteries

4-8 yr =

Single arterial suppy - Retinacular artery

>8 yr =

Retinacular Artery

Foveal artery


Retinacular Artery
Foveal artery
Metaphyseal artery


Cartilagenous growth plate - starts appearing at 4 yrs age so metaphyseal arteries don’t enter after 4 years of age. When growth plate disappers in adolescence, metaphyseal arteries enter epiphysis again. Foveal artery appears at 8 years of age.

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