Proximal Femur Fracture and Vascular Injury in Adults—Case Report^[*]

Abstract

Vascular complications in the surgical treatment of hip fractures are rare. Depending on the arterial injury, severe intraoperative bleeding or a subacute hematoma formation with arterial pseudoaneurysm development can occur. In the literature, the more frequently described complications are large local hematomas after osteosynthesis with sliding hip screws. This report shows a case of delayed arterial injury after proximal femur osteosynthesis.

Keywords

femoral fractures - vascular system injuries - bone screws - hip/surgery

^* Work performed at the Orthopedics and Traumatology Service, Hospital Santa Teresa, Petrópolis, RJ, Brazil. Originally published by Elsevier Ltda.

• Referências

• 1 Karanikas I, Lazarides M, Arvanitis D, Papayanopoulos G, Exarchou E, Dayantas J. Iatrogenic arterial trauma associated with hip fracture surgery. Acta Chir Belg 1993; 93 (06) 284-286
• 2 Klinger HM, Baums MH, Eckert M, Neugebauer R. [A comparative study of unstable per- and intertrochanteric femoral fractures treated with dynamic hip screw (DHS) and trochanteric butt-press plate vs. proximal femoral nail (PFN)]. Zentralbl Chir 2005; 130 (04) 301-306
• 3 Garrido-Gómez J, Garrido-Gómez MN, Arrabal-Polo MA, Garrido-Pareja F, Linares-Palomino JP. Iatrogenic false aneurysms. A rare complication of hip surgery. Hip Int 2012; 22 (04) 397-402
• 4 Barquet A, Gelink A, Giannoudis PV. Proximal femoral fractures and vascular injuries in adults: Incidence, aetiology and outcomes. Injury 2015; 46 (12) 2297-2313
• 5 Hamoui M, Larbi A, Bommart S, Fauré P, Largey A, Canovas F. False aneurysm of perforating branch of the profunda femoris artery following intertrochanteric fracture, a rare vascular complication: clinical, radiological features and management: case report and review of the literature. Eur J Orthop Surg Traumatol 2010; 20: 59-65
• 6 Neubauer T, Grechenig S, Leitner L, Auffarth A, Plecko M. Vascular complications in plating of the proximal femur: review. Arch Orthop Trauma Surg 2016; 136 (04) 539-551
• 7 Keel JD, Eyres KS. Vascular injury by an intertrochanteric fracture fragment. Injury 1993; 24 (05) 350-352
• 8 Entwisle JJ, De Nunzio M, Hinwood D. Case report: Transcatheter embolization of pseudoaneurysm of the profunda femoris artery complicating fracture of the femoral neck. Clin Radiol 2001; 56 (05) 424-427
• 9 Pradhan DJ, Juanteguy JM, Wilder RJ, Michelson E. Arterial injuries of the extremities associated with fractures. Arch Surg 1972; 105 (04) 582-585
• 10 Hanna GB, Holdsworth RJ, McCollum PT. Profunda femoris artery pseudoaneurysm following orthopaedic procedures. Injury 1994; 25 (07) 477-479