Late Presentation of an Iatrogenic Pseudoaneurysm of the Profunda Femoris Artery following Intramedullary Nailing

Introduction. Hip fractures are one of the most common osteoporotic fractures, and the incidence is expected to increase in the future. Vascular injury of the femoral vessels, although uncommon, is an intermittently reported complication in the treatment of proximal femoral fractures. This may be ia...

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Main Authors: Kira Vande Voorde, Jan Dauwe, Jan Van Oost
Format: Article
Language:English
Published: Wiley 2018-01-01
Series:Case Reports in Orthopedics
Online Access:http://dx.doi.org/10.1155/2018/8270256
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author Kira Vande Voorde
Jan Dauwe
Jan Van Oost
author_facet Kira Vande Voorde
Jan Dauwe
Jan Van Oost
author_sort Kira Vande Voorde
collection DOAJ
description Introduction. Hip fractures are one of the most common osteoporotic fractures, and the incidence is expected to increase in the future. Vascular injury of the femoral vessels, although uncommon, is an intermittently reported complication in the treatment of proximal femoral fractures. This may be iatrogenic or less frequently as a result of the fracture itself. The profunda femoris artery is most commonly involved, probably because of its close relationship to the femur in the subtrochanteric region. Case Presentation. We report a well-documented case of pseudoaneurysm of the profunda femoris artery after intramedullary nailing of an intertrochanteric femoral fracture. Arterial damage was due to overpenetration when drilling the distal locking hole. Because of the late presentation, pressure on the medial femoral diaphysis caused severe cortical scalloping. This resulted in an obvious radiographic image rarely reported before. Conclusion. This case report illustrates the uncommon complication of pseudoaneurysm after intramedullary hip nailing. Because of the risk of potentially limb- and life-threatening complications, we advise careful drilling and placement of the distal locking screw. Excessive screw length should be avoided. The injured limb should be returned to the neutral position and lower-limb traction should be reduced before drilling the distal locking hole.
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spelling doaj-art-07e5ec9655384f7e92574d04cb696a5b2025-08-20T03:55:28ZengWileyCase Reports in Orthopedics2090-67492090-67572018-01-01201810.1155/2018/82702568270256Late Presentation of an Iatrogenic Pseudoaneurysm of the Profunda Femoris Artery following Intramedullary NailingKira Vande Voorde0Jan Dauwe1Jan Van Oost2Department of Orthopaedic and Trauma Surgery, AZ Delta Hospital, BelgiumDepartment of Orthopaedic Surgery, University Hospitals Leuven, Leuven, BelgiumDepartment of Orthopaedic and Trauma Surgery, AZ Delta Hospital, BelgiumIntroduction. Hip fractures are one of the most common osteoporotic fractures, and the incidence is expected to increase in the future. Vascular injury of the femoral vessels, although uncommon, is an intermittently reported complication in the treatment of proximal femoral fractures. This may be iatrogenic or less frequently as a result of the fracture itself. The profunda femoris artery is most commonly involved, probably because of its close relationship to the femur in the subtrochanteric region. Case Presentation. We report a well-documented case of pseudoaneurysm of the profunda femoris artery after intramedullary nailing of an intertrochanteric femoral fracture. Arterial damage was due to overpenetration when drilling the distal locking hole. Because of the late presentation, pressure on the medial femoral diaphysis caused severe cortical scalloping. This resulted in an obvious radiographic image rarely reported before. Conclusion. This case report illustrates the uncommon complication of pseudoaneurysm after intramedullary hip nailing. Because of the risk of potentially limb- and life-threatening complications, we advise careful drilling and placement of the distal locking screw. Excessive screw length should be avoided. The injured limb should be returned to the neutral position and lower-limb traction should be reduced before drilling the distal locking hole.http://dx.doi.org/10.1155/2018/8270256
spellingShingle Kira Vande Voorde
Jan Dauwe
Jan Van Oost
Late Presentation of an Iatrogenic Pseudoaneurysm of the Profunda Femoris Artery following Intramedullary Nailing
Case Reports in Orthopedics
title Late Presentation of an Iatrogenic Pseudoaneurysm of the Profunda Femoris Artery following Intramedullary Nailing
title_full Late Presentation of an Iatrogenic Pseudoaneurysm of the Profunda Femoris Artery following Intramedullary Nailing
title_fullStr Late Presentation of an Iatrogenic Pseudoaneurysm of the Profunda Femoris Artery following Intramedullary Nailing
title_full_unstemmed Late Presentation of an Iatrogenic Pseudoaneurysm of the Profunda Femoris Artery following Intramedullary Nailing
title_short Late Presentation of an Iatrogenic Pseudoaneurysm of the Profunda Femoris Artery following Intramedullary Nailing
title_sort late presentation of an iatrogenic pseudoaneurysm of the profunda femoris artery following intramedullary nailing
url http://dx.doi.org/10.1155/2018/8270256
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AT jandauwe latepresentationofaniatrogenicpseudoaneurysmoftheprofundafemorisarteryfollowingintramedullarynailing
AT janvanoost latepresentationofaniatrogenicpseudoaneurysmoftheprofundafemorisarteryfollowingintramedullarynailing