Superficial Femoral Artery Injury Resulting From Cerclage Wiring During Revision THA

Aleto, Thomas; Ritter, Merrill A.; Berend, Michael E.

doi:10.1007/s11999-007-0109-z

Cited by 45 publications

(14 citation statements)

References 9 publications

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“…Although reportedly rare, risk of major vascular injury is there during the passage of cerclage wire. 24 , 25 We did not experience any such complications in our series; it is presumed that percutaneous cerclage passer device is valuable in this regard as it eases satisfactory passage and prevent inadvertent trajectory of wire.…”

Section: Discussionmentioning

confidence: 64%

Role of percutaneous cerclage wire in the management of subtrochanteric fractures treated with intramedullary nails

Trikha

Das

Agrawal

et al. 2018

Chinese Journal of Traumatology

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PurposeCerclage wire application has emerged as a potential therapeutic adjunct to intramedullary nailing for subtrochanteric fractures. But its popularity is plagued by the concern of possible negative effect on fracture zone biology. This study was intended to analyze the clinico-radiological outcome and complications associated with cerclage wire application.MethodsRetrospective analysis was performed on all the subtrochanteric fractures operated with intramedullary nailing between January 2012 and January 2016. After exclusion, 48 patients were available with an average follow-up of 20.8 months. Long oblique, spiral, spiral wedge or comminuted fracture configurations with butterfly fragments were particularly considered for cerclage wire application, which was employed by percutaneous cerclage passer in 21 patients. Assessment was done in terms of operation time, blood loss, quality of reduction, neck-shaft angle, follow-up redisplacement, union time, complications, and final functional evaluation by Merle d’Aubigne'-Postel score.ResultsAverage operation time and blood loss were significantly higher in cerclage group (p < 0.05). However, cerclage use substantially improved quality of reduction in terms of maximum cortical displacement (p = 0.003) and fracture angulation (p = 0.045); anatomical reduction was achieved in 95.23% of cases as compared to 74.07% without cerclage. Union time was shorter, although not statistically different (p = 0.208), in cerclage group. Four patients in non-cerclage group developed non-union, 2 of them had nail breakage. No infection or any other implant related complications were reported with cerclage use.ConclusionMinimally-invasive cerclage wire application has proved to be beneficial for anatomical reconstruction in difficult subtrochanteric fractures, whenever applicable, without any harmful effect on fracture biology.

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Section: Discussionmentioning

confidence: 64%

Role of percutaneous cerclage wire in the management of subtrochanteric fractures treated with intramedullary nails

Trikha

Das

Agrawal

et al. 2018

Chinese Journal of Traumatology

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“…Once they have occurred, however, the patient’s prognosis is poor, and other serious complications or sequelae may arise. Some case reports have described vascular injury during THA [3, 4, 9–11]. One reported cause of injury to the external iliac artery or femoral artery is inappropriate placement of the acetabular retractor [3, 10].…”

Section: Discussionmentioning

confidence: 99%

“…As the number of older people increases worldwide, the number of THA cases is predicted to further increase by 2030 [2]. Although the incidence of injuries to the femoral blood vessels in THA reportedly ranges from 0.1 to 0.3% [3, 4], such injuries cause extremely serious complications.…”

Section: Introductionmentioning

confidence: 99%

Risk of injury to the femoral blood vessels based on the extent of acetabular dysplasia in total hip arthroplasty

et al. 2019

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We evaluated the course of the femoral blood vessels of patients with acetabular dysplasia. Patients were divided into five groups: those with Crowe type I, II, III, and IV dysplastic hips and those with normal hips. A computed tomography-based hip navigation software was used to measure the distance between the femoral blood vessels and the anterior pelvic wall in four axial planes located 10–40 mm proximal to the pelvic teardrop. In Crowe Groups I through IV, the distance was shortest at a point 20 mm proximal to the pelvic teardrop. Furthermore, the distance decreased as the Crowe classification grade increased. Because the femoral blood vessels pass close to the pelvis in many patients in Crowe III and IV hips, caution is required during surgery in these patients.

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“…Currently, acetabular revision is still considered the greatest risk factor [19] , [20] . Muscle atrophy, skin scarring, and osteoarthritis can change normal anatomy [3] , [21] , [22] , [23] , [24] , thus allowing vascular injury to occur more easily. Acetabular displacement itself can sometimes cause vascular compression and thrombosis [3] , [16] , [23] , [25] .…”

Section: Discussionmentioning

confidence: 99%

“…Acetabular displacement itself can sometimes cause vascular compression and thrombosis [3] , [16] , [23] , [25] . It is believed that the risk of vascular complication associated with reoperation should be higher than that associated with the initial surgery [3] , [21] , [22] , [23] , [24] , [26] , [27] . However, Calligaro et al.…”

Section: Discussionmentioning

confidence: 99%

Femoral artery injury during total hip arthroplasty

Shen

Feng

et al. 2018

Arthroplasty Today

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There are an increasing number of vascular complications after hip replacement, some of which can be life-threatening. However, there are few reports of lower limb ischemic symptoms after undergoing an otherwise uncomplicated classic total hip replacement. We report a patient with low weight who developed postoperative limb ischemia resulting from blood clots caused by insertion of a Hohmann retractor close to small anterior acetabular osteophytes. Ultrasonography and angiography revealed her symptoms to be the result of femoral artery intimal injury with lower extremity arterial thrombosis, which led to pain, numbness, and decreased skin temperature. The patient underwent timely percutaneous intervention with a femoral artery stent, which relieved her symptoms. The discussion reviews femoral artery injury during total hip arthroplasty.

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Superficial Femoral Artery Injury Resulting From Cerclage Wiring During Revision THA

Cited by 45 publications

References 9 publications

Role of percutaneous cerclage wire in the management of subtrochanteric fractures treated with intramedullary nails

Role of percutaneous cerclage wire in the management of subtrochanteric fractures treated with intramedullary nails

Risk of injury to the femoral blood vessels based on the extent of acetabular dysplasia in total hip arthroplasty

Femoral artery injury during total hip arthroplasty

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