Das Aneurysma spurium – eine seltene Komplikation nach distaler Verriegelung eines Femurmarknagels

Abstract

A pseudoaneurysm is caused by an extravasal hematoma after vessel injury. Persistent blood supply via the afferent artery can lead to aneurysm growth with potential rupture of the lesion. We present a case of a 27-year-old man who developed three independent pseudoaneurysms after insertion of percutaneous distal locking bolts for static locking of an intramedullary femur nail. Color-coded Doppler sonography and intraarterial subtraction angiography were used to detect the lesion. Successful treatment consisted of endovascular embolization (coiling) with injection of a platinum coil into the aneurysm's supplying vessel. Pseudoaneurysm after fracture or fracture fixation represents a rare complication, but the risk of acute bleeding by pseudoaneurysm rupture should not be neglected.

Verletzung der A. profunda femoris mit transfusionspflichtiger Blutung durch sekundäre Dislokation des Trochanter minor nach Osteosynthese einer pertrochantären Femurfraktur

“…Barquet et al gaben 2015 in einem Review eine Inzidenz von 0,49 % an. Die zwei häufigsten Formen sind Lazerationen und Pseudoaneurysmata [9,10]. Die Symptomatik kann von lediglich atypischen inguinalen Schmerzen durch das paravasale Hämatom bis hin zum lebensbedrohlichen hypovolämischen Schock bei anämisierender Blutung gehen.…”

“…Auch Pseudoaneurysmata können rupturieren und sollten daher gefäßchirurgisch oder endovaskulär versorgt werden. Weitere potenzielle Komplikationen der Pseudoaneurysmata sind die Kompression benachbarter neurovas- kulärer Strukturen, Thromboembolien oder Infektionen [10].…”

Impending Compartment Syndrome Secondary to Pseudoaneurysm following Stabilization of Proximal Tibia Shaft Fracture: A Case Report

“…Postoperative complications are rare and these include infection, delayed fracture healing, non-union, and malunion [8]. Other rare complications have been reported in the literature, and one of these important complications is pseudoaneurysm formation, whether secondary to direct trauma or caused by the surgeon [9][10][11][12][13][14][15][16][17]. We report a 56-year-old male patient with an unusual presentation of impending compartment syndrome following intramedullary nail fixation, which developed during his clinical follow-up secondary to pseudoaneurysm formation.…”

Pseudoaneurysm of the anterior tibial artery after interlocking tibial nailing: an unexpected complication

“…Postoperative complications are rare and include infections, delayed fracture healing [ 1 ], and compartment syndrome [ 2 , 3 ]. Formation of pseudoaneurysms are rarely observed and can occur either as a direct result of the initial trauma to the extremity [ 4 – 6 ] or being caused iatrogenically [ 7 – 13 ]. The following case outlines the clinical presentation of a pseudoaneurysm of the anterior tibial artery and highlights the importance of early diagnosis and therapeutic intervention in this rare and thus easily overlooked postoperative complication in tibial fractures.…”