Journal of Musculoskeletal Trauma

Delayed Pseudoaneurysm of Deep Femoral Artery Caused by Migration of Lesser Trochanter, Subsequent to an Intertrochanteric Fracture Surgery - A Case Report -: Bum-Soo Kim, Seong-Tae Kim, Seungyup Shin, Chang Geun Yu; J Korean Fract Soc 2021;34(2):76-79. Published online April 30, 2021; DOI: https://doi.org/10.12671/jkfs.2021.34.2.76

Abstract PDF: The lesser trochanteric fracture is commonly found amongst intertrochanteric fractures, where pseudoaneurysm of the femoral artery is a rare complication. A pseudoaneurysm could develop due to the penetration injury of the artery by the bone fragment during occurrence of the fracture, or by the insertion of screws during the surgical procedure. Minimal complication is seen when the lesser trochanter is not fixed during the intertrochanteric fracture surgery. However, in the current case, the authors experienced appearance of a delayed pseudoaneurysm of the deep femoral artery caused by migration of the lesser trochanter, which was successfully treated by excision.

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Pseudoaneurysm of the Anterior Tibial Artery after Reduction with Pointed Bone Reduction Forceps on a Spiral Fracture of the Distal Tibia: A Case Report: Hyunseung Yoo, Youngho Cho, Seongmun Hwang; J Korean Fract Soc 2019;32(1):43-46. Published online January 31, 2019; DOI: https://doi.org/10.12671/jkfs.2019.32.1.43

Abstract PDF: This paper reports a pseudoaneurysm of the anterior tibial artery after reduction with pointed bone reduction forceps on a spiral fracture of the distal tibia. Most reported injuries occurred at the proximal part of anterior tibial artery during drilling of the proximal tibia. To the best of the authors' knowledge, injury of the distal part of anterior tibial artery has never been reported. This paper describes a 54-year-old woman with a pseudoaneurysm of the anterior tibial artery clinically detected 11 weeks after the index surgery. This report highlights the need for surgeons to be aware of and careful about this complication during and after surgical intervention.

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Huge Pseudoaneurysm of Popliteal Artery Following Conservative Treatment of a Distal Femur Fracture: A Case Report: Won Chul Cho, Chong Bin Park, Young Jun Choi, Hyun Il Lee, Hee Jae Won, Jae Kwang Hwang; J Korean Fract Soc 2016;29(2):137-142. Published online April 30, 2016; DOI: https://doi.org/10.12671/jkfs.2016.29.2.137

Abstract PDF: A pseudoaneurysm is a contained arterial disruption in the intimal and medial layers of an arterial wall. It may originate from a perforation caused by traumatic or iatrogenic injury or the dehiscence of a surgical anastomosis. Because of its insidious onset and delayed presentation, orthopaedic surgeons should be aware of the possibility of such a lesion after an initial trauma. We report on a case of a delayed huge pseudoaneurysm of the popliteal artery that occurred 11 months after conservative treatment of a supracondylar fracture of the femur in order to keep in mind the possibility of the delayed presentation of vascular injury after a distal femur fracture.

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Deep Femoral Vessel Injury Following Subtrochanteric Hip Fracture: A Case Report: Jae Hyuk Yang, Jung Ro Yoon, Kyu Bok Kang, Ho Hyun Yun, Young Soo Shin, Yun Ku Cho; J Korean Fract Soc 2012;25(1):64-68. Published online January 31, 2012; DOI: https://doi.org/10.12671/jkfs.2012.25.1.64

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Arterial trauma associated with hip fracture treatment is still a rare complication. We present a case in which an arterial injury was discovered during closed reduction and intramedullary nail fixation of a subtrochanteric hip fracture. The preoperative thigh circumference was increased due to severe swelling, and the vascular injury was located substantially proximal to the fracture and the instrumentation area. An interventional angiogram revealed a damaged vessel originating from one of the minor proximal branches of the right deep femoral artery while filling a 2 cm-sized pseudoaneurysm. Embolization was performed without further complications.

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Proximal femoral fractures and vascular injuries in adults: Incidence, aetiology and outcomes
Antonio Barquet, Andrés Gelink, Peter V. Giannoudis
Injury.2015; 46(12): 2297. CrossRef
Pertrochanteric Hip Fracture: A “Routine” Fracture With a Potentially Devastating Vascular Complication
Matthew Patrick Sullivan, Mara Lynne Schenker, Samir Mehta
Orthopedics.2015;[Epub] CrossRef

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Posterior Thigh Compartment Syndrome as a Result of Pseudoaneurysm of the Popliteal Artery in the Distal Femoral Fracture: A Case Report: Seoung Jun Lee; J Korean Fract Soc 2007;20(3):277-281. Published online July 31, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.3.277

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Compartment syndrome of the thigh is a rare condition and usually occurs in the anterior compartment. It is frequently caused by muscle injury, femur fracture, muscle overuse and vessel injury, but there have been few reports about posterior thigh compartment syndrome caused by pseudoaneurysm of the popliteal artery after fixation of distal femoral fracture with the retrograde intramedullary nail. We report a case of posterior thigh compartment syndrome caused by pseudoaneurysm of the popliteal artery, and report the clinical progression and result of our case.

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Huge Pseudoaneurysm of Popliteal Artery Following Conservative Treatment of a Distal Femur Fracture: A Case Report
Won-Chul Cho, Chong Bin Park, Young-Jun Choi, Hyun-Il Lee, Hee-Jae Won, Jae-Kwang Hwang
Journal of the Korean Fracture Society.2016; 29(2): 137. CrossRef
Is CT Angiography a Reliable Tool for Diagnosis of Traumatic Vessel Injury in the Lower Extremities?
Jong-Hyuk Park, Kwang-Bok Lee, Hyuk Park, Jun-Mo Lee
Journal of the Korean Fracture Society.2012; 25(1): 26. CrossRef

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Traumatic Pseudoaneurysm of Posterior Tibial Artery in a Child: A Case Report: Tai Seung Kim, Kuhn Sung Whang, Woo Young Seo; J Korean Fract Soc 2007;20(1):83-85. Published online January 31, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.1.83

Abstract PDF

Pseudoaneurysm is one of the complications of arterial injuries by trauma. The case report in children is rare, although not in adult. A 7-year and 10-month girl was visited with the complaints of pain and a mass in her right leg. At first, the radiograph of right tibia showed a remarkable cortical erosion from without, suggesting mass effect by a soft tissue tumor. She had a history of fracture of right tibia, and then manipulative reduction and K-wire fixation at 11 months ago. Arteriography showed a formation of the pseudoaneurysm originated from the posterior tibial artery. The operation was done through the ligation of artery at proximal and distal to pseudoaneurysm, and then excision of mass. At 5 year follow-up, the configuration and function of right foot was normal. Eventually, the cause of the mass formation is thought by the trauma of fracture fragment at the time of accidents, but the possibility of penetrated injuries by K-wire should be ruled out, which is used frequently in children's fracture. We experienced a case of traumatic pseudoaneurysm of posterior tibal artery with tibial fracture, especially occurred in pediatric patient, and presented the result of long-term follow-up.

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Coil Embolization of a Pseudoaneurysm of the Anterior Tibial Artery: A Case Report
Tae-Hyun Wang, Hyung-Lae Cho, Ki-Bong Park, Duc-Hee Kim
Journal of Korean Foot and Ankle Society.2016; 20(1): 43. CrossRef

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Superior Gluteal Artery Pseudoaneurysm without Pelvic Bone Fracture: A Case Report: Hyung Ku Yoon, Jae Hwa Kim, Man Deuk Kim, Hyung Kun Park, Soon Chul Lee; J Korean Fract Soc 2005;18(2):205-208. Published online April 30, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.2.205

Abstract PDF: Pseudoaneurysm is defined as the aneurysmal cyst resulted from partial or total rupture of vessel membrane, and it can be caused by fracture, operation, laceration, blunt trauma, osteochondroma and so on. When the displaced pelvic bone fracture is diagnosed, the traumatic pseudoaneurysm, which is frequently related by the direct injury of vessel, is one of the common complications, and it can result the massive hemorrhage even death. In case of the displaced pelvic bone fracture, surgeon should check the hemoglobin level and vital sign carefully for the possibility of vascular injury. Authors report the rare case of superior gluteal artery pseudoaneurysm without pelvic bone fractrure.

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Pseudoaneurysm of Superficial Femoral Artery Following Proximal Femoral Nail Fixation: Hyung Ku Yoon, Byung Kuk Kim, Dong Eun Shin, Man Deuk Kim, Ji Hoon Chang; J Korean Fract Soc 2004;17(3):221-223. Published online July 31, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.3.221

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Pseudoaneurysm of the femoral artery is a rare complication following the fixation of the fracture of proximal femur or protruded bony fragment and reports injuring on superficial femoral artery is very rare compared to deep femoral artery complicated by the insertion of distal interlocking screw. The chance of injuring superficial femoral artery may increase by deep insertion of drill bit or the repetitive arterial pulsation on prominent distal interlocking screw tip during the perioperative period. Authors experienced one case of injury on the superficial femoral artery postoperative 42 hours followed by the use of proximal femoral nail advocated by the AO group recently and would like to call attention upon the possibilities of vessel injury complicated with the use of the distal interlocking screw.

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Huge Pseudoaneurysm of Popliteal Artery Following Conservative Treatment of a Distal Femur Fracture: A Case Report
Won-Chul Cho, Chong Bin Park, Young-Jun Choi, Hyun-Il Lee, Hee-Jae Won, Jae-Kwang Hwang
Journal of the Korean Fracture Society.2016; 29(2): 137. CrossRef
Proximal femoral fractures and vascular injuries in adults: Incidence, aetiology and outcomes
Antonio Barquet, Andrés Gelink, Peter V. Giannoudis
Injury.2015; 46(12): 2297. CrossRef
Delayed Pseudoaneurysm of the Femoral Artery after Intramedullary Nailing of a Femur Shaft Fracture
Hyun Cheol Oh, Jae Wan Suh, Dae Kyung Kwak, Han Kook Yoon
Journal of the Korean Orthopaedic Association.2013; 48(3): 240. CrossRef
Diagnosis and Treatment for Delayed Pseudoaneurysm of Deep Femoral Artery - A Case Report -
Seok-Hyun Lee, Ji-Hyun Ahn
The Journal of the Korean Orthopaedic Association.2008; 43(1): 118. CrossRef

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Consumptive Coagulopathy Secondary to a Traumatic False Aneurysm of Deep Femoral Artery: Duke Whan Chung, Hwi Joong Yoon, Chang Moo Yim, Young Soo Chun, Hyun Ju Park; J Korean Soc Fract 1998;11(1):85-90. Published online January 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.1.85

Abstract PDF: A case of consumptive coagulopathy due to pseudoaneurysm, which occured as a complication of intramedullary nailing, was rarely reported. Pseudoaneurysm of peripheral artery is presented with pulsating mass and may show extrinsic indentations of the adjacent bone. The coagulopathy and bleeding responded to surgical elimination of the fistula and aneurysm. Diffuse intravascular coagulopathy or consumptive coagulopathy is infrequently associated with pseudoaneurysm of deep femoral artery. Laceration of major arteries are more common in open than in closed fractures. They usually occur only when a major artery is in close proximity to bone as complications to frractures. Diffuse intravascular coagulopathy or consumptive coagulopathy is characterized clinically by excessive bleeding, ecchymosis and petechiae and by laboratory evidence of a disease in the numbers of platelets and amount of fibrinogen and an increase of fibrin degradation products with prolonged prothrombin and partial thromboplastin times. When the two coexist, they create a difficult clinical problem that reuires optimal medical and surgical treatments. If the appropriate treatment was delayed, serious complication such as sepsis or death could be occured. Prompt recongnition through appropriate laboratory tests and early surgical intervention was indicated essentially. We are reporting one case of coagulopathy associated with pseudoaneurysm of deep femoral artery that presented to the broad clinical picture.

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