**Question:** A 75-year-old woman is admitted to the hospital after falling in her bathroom. Radiographic examination reveals an extracapsular fracture of the femoral neck. Which artery is most likely at risk for injury?

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**Core Concept:** Extracapsular fractures of the femoral neck usually involve the neck of the femur, which is located between the femoral head and the lesser trochanter. The femoral neck contains the femoral artery and vein, which are essential for blood supply to the lower limbs.

**Why the Correct Answer is Right:** In this case, the extracapsular fracture is placing significant pressure on the femoral neck, making the artery at risk due to the potential for direct compression or injury to the vessel.

In the femoral neck, the **Ascending branch of the profunda femoris artery** is most likely at risk for injury. This branch arises from the profunda femoris artery, which is a branch of the external iliac artery. The ascending branch of the profunda femoris artery supplies blood to the superficial femoral artery and the popliteal artery.

**Why Each Wrong Option is Incorrect:**

A. **Incorrect:** The femoral artery and vein are located within the femoral canal, which is separate from the femoral neck. Therefore, the femoral artery is not at risk in this scenario.

B. **Incorrect:** The femoral vein is located within the femoral canal and is not at risk due to its location in the femoral canal separate from the femoral neck.

C. **Incorrect:** The iliac artery is located in the pelvic region, far away from the femoral neck, making it irrelevant to the scenario.

D. **Incorrect:** The saphenous artery is a terminal branch of the deep circumflex iliac artery, which is located in the thigh and is unrelated to the femoral neck fracture.

**Clinical Pearl:** Extracapsular femoral neck fractures should be managed surgically for proper blood supply restoration, and careful consideration should be given to the vascular structures in the area to prevent complications like avascular necrosis and limb loss.