Femoral hernias pass through the narrow femoral canal, which has rigid borders limiting expansion. This anatomical constraint predisposes femoral hernias to incarceration and subsequent strangulation, as the blood supply can be easily compromised. Compared to other hernia types, femoral hernias have a significantly higher risk of vascular compromise leading to ischemia and necrosis of the entrapped bowel. Prompt surgical intervention is required to prevent serious complications. Therefore, strangulation is the most common and clinically significant complication associated with femoral hernias.

Reference: Schwartz's Principles of Surgery, 11th Edition.