Profunda Femoris Arterial Laceration Secondary to Intertrochanteric Hip Fracture Fragments

False Aneurysm of the Profunda Artery Complicating Dynamic Hip Screw Osteosynthesis

“…Various injury mechanisms have been suggested in the literature [2,4,6]: perforation caused by drills shooting too far beyond the medial cortex, or traction and compression forces applied by retractors positioned blindly within the posteromedial aspect of the proximal femur. Prominent screws are more likely to cause damage by directly and repeatedly impinging on the vessel causing gradual erosion during motion postoperatively.…”

“…Contrast-enhanced CT scan and angiography confirm the diagnosis. In previously reported cases of iatrogenic false aneurysm of the profunda artery, surgical repair (ligation and excision, suture of the arterial defect) has been advocated [1][2][3][4][5][6]. However, direct treatment at the time of diagnosis by means of embolization would save time and eliminate the risks associated with a possible surgical procedure.…”

False aneurysm of the femoral artery as a late complication of an intertrochanteric fracture

“…Although intertrochanteric fractures of the femur are common, an associated false aneurysm is rare [1,5,7,9,12,14]. The aneurysm arises from disruption of the arterial wall with extravasation of blood which forms an encapsulated haematoma.…”

“…The diagnosis may be delayed, even for as long as a year [7,9]. The unexplained anaemia, haematoma and pain were the signs which led us to suspect the diagnosis a month after the injury.…”

Avascular Necrosis of the Femoral Head in Pertrochanteric Fractures

“…[40][41][42] Vessels also may be injured by being overstretched secondary to marked dislocation of fragments or by direct pressure of fragments on the vessel. The extent of dislocation may also be influenced by the intensity of violence (high-energy trauma).…”