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.
Introduction Pediatric pelvic fractures are uncommon and are usually the result of a high-energy mechanism. Bilateral symmetric fracture of the iliac bone is an extremely uncommon clinical entity that is not yet classified in the current classification systems of pelvic fractures. It mostly occurs among young patients with a history of a seat-belt injury. Patients usually complain of severe hip pain after an accident. Case Report A 5-year-old male was transported to our hospital after a car accident. He was complaining of vague pain in the pelvic region after he was exposed to an acceleration-deceleration trauma, seated in a children's car seat. Radiograph of the pelvis revealed a rare image of bilateral symmetric iliac fractures. Iliac bone fracture was suspected, which was also evident on pelvis and hip magnetic resonance imaging. Additional ultrasound of the abdomen was negative. He was hospitalized for observation, and after one day, he could be discharged from the hospital without complications. Policlinic control after three, six, and ten weeks showed favorable clinical and radiographic evolution. Conclusion Physicians should be aware of our report, which highlights a patient with the rare clinical condition of a bilateral symmetric fracture of the iliac bone after an acceleration-deceleration trauma. The differential diagnosis of acute hip pain should be considered for young patients. Always keep in mind additional injuries because of the high-energy trauma.
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