The incidence of life threatening iatrogenic vessel injury following closed or open reduction and internal fixation of intertrochanteric femoral factures

Segal, David; Yaacobi, Eyal; Marom, Niv; Feldman, Viktor; Aliev, E.; Palmanovich, Ezequiel; Bartal, Gabriel; Brin, Yaron S.

doi:10.1007/s00264-017-3545-8

Cited by 13 publications

(9 citation statements)

References 36 publications

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“… 10 Pseudoaneurysms of the femoral artery branches were reported in 0.2% of cases, caused by overpenetration of the drill bit or irritation of the protruding distal locking screw. 41 , 42 …”

Section: Resultsmentioning

confidence: 99%

Distal interlocking for short trochanteric nails: static, dynamic or no locking? Review of the literature and decision algorithm

et al. 2020

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Pertrochanteric hip fractures are among the most common and the use of short cephalomedullary nails as the treatment of choice is increasing. A systematic review regarding distal locking options for short cephalomedullary nails was undertaken using Medline/PubMed®, Embase® and Cochrane Library® in order to evaluate current indications, associated complications and to provide treatment recommendations. The results seem to support the use of distal static locking for unstable fractures, dynamic locking for length stable/rotational unstable fractures and no locking for stable fractures. Complications associated with distal locking include iatrogenic fractures, thigh pain, delayed union and nonunion, implant failure, screw loosening and breaking, drill bit breaking, soft tissue irritation, femoral artery branch injury, intramuscular haematoma and compartment syndrome. It is also associated with longer operative time and radiation exposure. In unlocked constructs, dorsomedial comminution and nail/medullary canal mismatch contribute to peri-implant fractures. Anterior cortical impingement is associated with cut-out and nonunion. Most studies comparing distally locked and unlocked nails report a short follow-up. Distal locking mode should be based on the fracture’s stability. Cite this article: EFORT Open Rev 2020;5:421-429. DOI: 10.1302/2058-5241.5.190045

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Section: Resultsmentioning

confidence: 99%

Distal interlocking for short trochanteric nails: static, dynamic or no locking? Review of the literature and decision algorithm

et al. 2020

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“…6 En investigaciones más recientes, se ha estimado que la incidencia de lesiones vasculares tras una fractura de cadera oscila entre el 0,2% y el 0,49%. 7,8 En una serie en la que se revisaron retrospectivamente más de 7000 casos de fractura de cadera, solo se hallaron cuatro casos con un seudoaneurisma como complicación. 4 El compromiso del territorio lateral del sistema profundo de la arteria femoral es mucho menos frecuente que el medial.…”

Section: Discussionunclassified

“…Se han propuesto distintos algoritmos de tratamiento. 7,10 Si el paciente es asintomático y el seudoaneurisma mide <3 cm, se puede tratar de manera conservadora y esperar entre 4 y 6 semanas a que se produzca la resolución espontánea. 16 Si no cumple estos criterios, se recomienda la reparación mediante cirugía abierta o embolización transcutánea.…”

Section: Discussionunclassified

Seudoaneurisma de la arteria femoral lateral: revisión sistemática a propósito de una complicación infrecuente en pacientes con fracturas pertrocantéricas

Agustin

Sauras

Granados

et al. 2022

Rev. Asoc. Arg. Ort. y Traumatol

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Introducción: Se presenta un caso clínico de seudoaneurisma de la arteria femoral circunfleja lateral secundario a una fractura pertrocantérica de cadera. Materiales y Métodos: Como el cuadro y su localización son infrecuentes, se llevó a cabo una revisión bibliográfica sistematizada que incluyó todos los casos publicados sobre esta enfermedad (n = 40) en los últimos 15 años. Resultados: No se hallaron asociaciones estadísticamente significativas entre ninguna de las variables estudiadas. Sin embargo, parece existir cierto consenso en mantener una alta sospecha clínica para una intervención precoz y así obtener mejores resultados. Tanto su etiología como su localización se relacionan con la morfología de la fractura, el gesto quirúrgico y el material de osteosíntesis. Asimismo, hay una tendencia mayor a utilizar la angiotomografía para el diagnóstico y la localización del seudoaneurisma. Conclusiones: Nuestra paciente es el primer caso de resolución espontánea. Es fundamental conocer estacomplicación tan poco frecuente para optimizar los resultados terapéuticos. Esta revisión, la más reciente sobre el tema, es muy útil para enumerar y subrayar los aspectos más importantes sobre el manejo y la prevención de los seudoaneurismas secundarios a una fractura de cadera.

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“…10 These lesions are usually due to drilling, screw insertion, sometimes to the incorrect introduction of the guide wire in nailing but can also occur by the fracture in itself. 11 There is a possibility of rupturing the already calcicifed artery seen on the pre-operative and post-operative radiograph by traction injury while trying to align the fracture on a traction table.…”

Section: Case Reportmentioning

confidence: 99%

Pseudoaneurysm of profunda femoris artery: a rare complication after intramedullary fixation for an intertrochanteric femur fracture

2019

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Intertrochanteric fracture fixation with a trochanteric femoral nail rarely leads to any vascular or neurological complications. The aim of this case report is to identify a patient with post-operative Pseudoaneurysm of profunda femoris artery and how to manage it. We report a case of 79-year-old male who developed a Pseudoaneurysm of the profunda femoris artery 3 days after intramedullary femoral nailing for a intertrochanteric femur fracture. Percutaneous embolization was performed with subsequent resolution of the symptoms. Diagnosis of vascular complications after hip surgery may be very challenging because symptoms are often nonspecific. Despite their rarity, it is important to know this type of complications to address the diagnostic pathway in the right direction and to treat them promptly.

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The incidence of life threatening iatrogenic vessel injury following closed or open reduction and internal fixation of intertrochanteric femoral factures

Abstract: A vascular injury due to internal fixation of a proximal AO31A femoral fracture is a rare complication.

Cited by 13 publications

References 36 publications

Distal interlocking for short trochanteric nails: static, dynamic or no locking? Review of the literature and decision algorithm

Distal interlocking for short trochanteric nails: static, dynamic or no locking? Review of the literature and decision algorithm

Seudoaneurisma de la arteria femoral lateral: revisión sistemática a propósito de una complicación infrecuente en pacientes con fracturas pertrocantéricas

Pseudoaneurysm of profunda femoris artery: a rare complication after intramedullary fixation for an intertrochanteric femur fracture

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