Missed diagnosis of false aneurysm of the superficial femoral artery after closed complex fracture of the distal femur

Lazarov, M.; Bracht, Hans Van Der; Victor, Jan; Stuyts, Bart

doi:10.1016/j.otsr.2014.04.005

Cited by 14 publications

(5 citation statements)

References 10 publications

(15 reference statements)

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“…With the increasing incidence of proximal femoral fractures, the need to pay attention to the treatment of complications has also increased [ 7 ]. Iatrogenic vascular injuries are more severe complications and are difficult to diagnose early [ 8 ]. Understanding the anatomical relationship between the femur and femoral artery along with its branches is critical in preventing iatrogenic vascular injuries.…”

Section: Discussionmentioning

confidence: 99%

Iatrogenic Injury to Profunda Femoris During a Dynamic Hip Screw Fixation for Intertrochanteric Fracture

Lal¹,

Jesudason²,

Gwyn³

2023

Cureus

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Section: Discussionmentioning

confidence: 99%

Iatrogenic Injury to Profunda Femoris During a Dynamic Hip Screw Fixation for Intertrochanteric Fracture

Lal¹,

Jesudason²,

Gwyn³

2023

Cureus

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“…The latter includes sharp bone fragments, scar tissue, and direct trauma (open injuries), whereas the former consists of insertion plate screws or locking bolts of intramedullary nails, and also malpositioned retractors, plunging drill bits, and the movements of fragments during reduction procedures. 13,14 Manner et al emphasized that traction on a fracture table tightens the femoral muscles and additionally reduces the local mobility of the DFA. 15 Yang et al demonstrated the influence of the extremity's position on the fracture table on the distances between femoral vessels and the medial femoral cortex.…”

Section: Discussionmentioning

confidence: 99%

Vascular injuries due to cerclage passer: Relevant anatomy and note of caution

Devendra

Avinash

Chidambaram

et al. 2018

J Orthop Surg (Hong Kong)

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Purpose: The cerclage passer instrument was introduced for aiding percutaneous reduction in spiral femur fractures, thereby overcoming the risk of devascularization of the fracture ends commonly associated with traditional open cerclage wiring techniques. This may, however, predispose to iatrogenic vascular injuries owing to the proximity of the vessels and several other factors. We report four cases with femoral artery (superficial and deep) injuries caused by the cerclage passer in proximal femur and distal femur shaft fractures and incidence of these injuries in our institution. Methods: Retrospective analysis of hospital records of femoral fractures from 2011 to 2015. All cases of femoral fractures and periprosthetic femoral fractures with cerclage wiring done using the standard or the Synthes ® cerclage passer were included. Cases with wiring done for trochanteric fractures and other locations were excluded. Results: Incidence of vascular injuries due to the cerclage passer in proximal femur shaft fractures was 1.59%, whereas in distal femur shaft fractures it was 7.14%. There were two patients with a deep femoral artery (DFA) system injury and two with a superficial femoral artery (SFA) injury caused by the cerclage passer (Synthes) in two proximal femur shaft and two distal femur shaft fractures, respectively. End-to-end anastomosis for the SFA and ligation for DFA system injuries were used, with an uneventful postoperative period in all patients. Conclusion: Caution and accuracy is imperative to avoid vascular injuries while using the cerclage passer in femur fractures, and strict vigilance is essential for early identification and prompt management.

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“…The increasing incidence of PFF draws more attention to treatment and relevant complications [1,13,14], of which iatrogenic vascular injury is a severe complication and is difficult to diagnose early [15,16]. Identifying the relationship between femoral arteries and femur in the medial aspect of the femur is critical for prevention of iatrogenic vascular injury in internal fixation of PFF.…”

Section: Discussionmentioning

confidence: 99%

Relationship Between Femur and Femoral Arteries for Identifying Risk Factors for Vascular Injury

Sun

Fan

et al. 2017

Med Sci Monit

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BackgroundThis study aimed to identify risk factors for vascular injury in proximal femoral fracture through identifying frequency and distances between femur and femoral arteries with computed tomography angiography and 3-dimensional reconstruction.Material/MethodsIn a series of 400 participants, based on measurement results regarding the distribution of femoral arteries in the medial femur, the femoral portion covering that part was divided into levels A–E. The center region, margin region, and risky area in the medial femur were defined. The frequency of femoral arteries and interested shortest distance between the outer femur and superficial, deep, and perforating femoral arteries (SFAs, DFAs, and PFAs) in the center region, margin region, and risky area at each level were recorded.ResultsThere were 173 males and 227 females (average age: 63.61±19.18 years) in this study. The starting point and end point for femoral arteries in the medial femur were from 22.55±4.23% to 54.56±8.39% of the whole femur. The femoral arteries in the medial femur mainly were distributed at levels B (88.2%), C (65.9%), and D (40.6%). The femoral arteries in center regions in the risky area, most of which were DFAs and PFAs, were mainly concentrated at levels B (26.93%) and C (11.81%).ConclusionsThe mid-shaft level was the most risky level, and the DFAs and PFAs were easier to injure than the SFAs when performing internal fixation of proximal femoral fracture. We recommended that great attention be paid to drill and screw insertion around the mid-shaft level for prevention of iatrogenic vascular injury.

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Missed diagnosis of false aneurysm of the superficial femoral artery after closed complex fracture of the distal femur

Cited by 14 publications

References 10 publications

Iatrogenic Injury to Profunda Femoris During a Dynamic Hip Screw Fixation for Intertrochanteric Fracture

Iatrogenic Injury to Profunda Femoris During a Dynamic Hip Screw Fixation for Intertrochanteric Fracture

Vascular injuries due to cerclage passer: Relevant anatomy and note of caution

Relationship Between Femur and Femoral Arteries for Identifying Risk Factors for Vascular Injury

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