Secondary profunda femoris artery injury after intramedullary femoral nailing in a geriatric pertrochanteric femur fracture: case report

Late deep femoral artery injury after intertrochanteric hip fracture treatment: A case report

“…The Doppler ultrasonography did not diagnose arterial bleeding because the arterial leak was masked by high-pressured hematoma. The classical clinical scenario of acute hemorrhage (hypotension, tachycardia, rapid hemoglobin decline) [ 4 , 7 ] was not applicable in our case because of the gradual nature of the lesion and the tamponade effect of the formed hematoma.…”

“…Other possible factors that may also predispose to arterial injury are the use of an oversize perineal pole, excessive traction, or positioning the limb in adduction and internal rotation. This position forces the deep femoral artery and its branches to be near the medial aspect of the sub-trochanteric femur, making them vulnerable to injury by fracture fragments or screws [ [1] , [2] , [3] , [4] , [5] , [6] , [7] , [8] , [9] ].…”

“…Acute perioperative bleeding usually presents with hemorrhagic syndrome (ex. rapid decrease in hemoglobin, tachycardia, hypotension or even shock) painful swelling of the thigh with eventual palpable pulsation or an audible bruit, and rarely a compartment syndrome of the thigh [ 3 , 4 , 6 , 12 ]. In chronic cases, typical clinical features include increased limb diameter (because of the swelling), pain worsening, elevated skin temperature, venous dilatation, and progressive anemia [ 7 ].…”

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

“…Die sekundäre Dislokation eines Knochenfragments mit nachfolgender Gefäßverletzung ist sehr selten. Sie wird hauptsächlich in Fallberichten beschrieben [7,8]. Barquet et al gaben 2015 in einem Review eine Inzidenz von 0,49 % an.…”