Neglected fracture shaft femur presenting with pseudoaneurysm: a case report

Authors

  • Pankaj Tathe Government Medical College, Nagpur, Maharashtra, India
  • Saurabh Sah Indhira Gandhi Government Medical College, Nagpur, Maharashtra, India
  • Prateek Jain Government Medical College, Nagpur, Maharashtra, India
  • Ayush Mittal Government Medical College, Nagpur, Maharashtra, India
  • Chandan Arora Government Medical College, Nagpur, Maharashtra, India

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20230480

Keywords:

Femur fracture, Pseudoaneurysm, FAPs

Abstract

A pseudoaneurysm is a collection of blood leaking from a damaged arterial wall. Development of the false aneurysm is due to either initial injury of the vessel or is a complication of internal fixation of the femoral fracture. Femoral artery pseudoaneurysms (FAPs) may close spontaneously if the tear is small enough to allow for clotting and sealing. On the other hand, rupture of the aneurysm can trigger thrombosis, distal embolization and compression of adjacent structures. We present a case of left superficial femoral arterial pseudoaneurysm in a 36-year-old male with fracture of left femoral shaft. A 36-year-old male with history of road traffic accident presented to our institute with pain and swelling in left thigh. Patient was investigated and diagnosed with fracture left femoral shaft with a pseudoaneurysm of the left superficial femoral artery (SFA). Stenting was done for SFA followed by open reduction and internal fixation of the femoral shaft fracture. Such cases require multidisciplinary approach and a proper planning with involvement of different medical specialities to achieve optimal results and to minimise any intraoperative and post operative complications.

References

Chong KC, Yap EC, Lam KS, Low BY. Profunda femoris artery pseudoaneurysm presenting with triad of thigh swelling, bleeding and anaemia. Ann Acad Med Singap. 2004;33(2):267-9.

Canbaz S, Acipayam M, Gurbuz H, Duran E. False aneurysm of perforating branch of the profunda femoris artery after external fixation for a complicated femur fracture. J Cardiovasc Surg. 2002;43(4):519-22.

Hanna GB, Holdsworth RJ, McCollum PT. Profunda femoris artery pseudoaneurysm following orthopaedic procedures. Injury. 1994; 25:477-9.

Saad NE, Saad WE, Davies MG, Waldman DL, Fultz PJ, Rubens DJ. Pseudoaneurysms and the role of the minimally invasive techniques in their management. Radiographics. 2005;25:S173-89.

Bozgeyik Z, Ozdemir H, Orhan I, Cihangiroglu M, Cetinkaya Z. Pseudoaneurysm andrenal arteriovenous fistula after nephrectomy: two cases treated by transcatheter coil embolization. Emerg Radiol. 2008;15:119e22.

Taneja M, Lath N, Soo TB, Hiong TK, Htoo MM, Richard L, Fui AC. Renal artery stump to inferior vena cava fistula: unusual clinical presentation and transcatheter embolization with the Amplatzer vascular plug, Cardiovasc. Interv Radiol. 2008;31(2):S92e5.

Tiwary SK, Kumar S, Khanna R, Khanna AK. Iatrogenic femoral artery aneurysms in orthopaedic practice. ANZ J Surg. 2007;77:899-901.

Schwartz LB, Clark ET, Gewertz BL. Anastomotic and other pseudoaneurysms, in: R.B. Rutherford (Ed.), Vascular Surgery, 5th ed., Saunders, Philadelphia, Pa. 2000;752-63.

Dhal A, Chadha M, Lal H. Encounters with pseudoaneurysms in orthopaedic practice. Injury. 2001;32(10):771-8.

Zimon AE, Hwang JK, Principe DL, Bahadosingh RO. Pseudoaneurysm of the uterine artery. Obstet Gynecol. 1999;94(5-2):827-30.

Entwisle JJ, De Nunzio M, Hinwood D. Transcatheter embolization of pseudeoaneurysm of the profunda femoris artery complicating fracture of the femoral neck. Clin Radiol. 2001;56:424-7.

Valli F, Teli MGA, Innocenti M, Vercelli R, Prestamburgo D. Profunda femoris artery pseudoaneurysm following revision for femoral shaft fracture non union. World J Orthop. 2013;18(3):154-6.

Miller-Thomas MM, West OC, Cohen AM. Diagnosing traumatic arterial injury in the extremities with CT angiography: pearls and pitfalls. Radiographics. 2005;25(1):S133-42.

Middleton WD, Dasyam A, Teefey SA. Diagnosis and treatment of iatrogenic femoral artery pseudoaneurysms. Ultrasound Q. 2005;21:3e17.

Toursarkissian B, Allen BT, Petrinec D, Thompson RW, Rubin BG, Reilly JM et al. Spontaneous closure of selected iatrogenic pseudoaneurysms and arteriovenous fistulae. J Vasc Surg. 1997;25:803e8.

Ritchie ED, Haverkamp D, Schiphorst TJMJ, Bosscha K. False aneurysm of the profunda femoris artery, a rare complication of a proximal femur fracture. Acta Orthop Belg. 2007;73:530-a2.

Downloads

Published

2023-02-24

Issue

Section

Case Reports