J Korean Fract Soc.  2012 Jan;25(1):64-68. 10.12671/jkfs.2012.25.1.64.

Deep Femoral Vessel Injury Following Subtrochanteric Hip Fracture: A Case Report

• Yang JH
• Yoon JR
• Kang KB
• Yun HH
• Shin YS
• Cho YK

• KMID: 1434113
• DOI: http://doi.org/10.12671/jkfs.2012.25.1.64

Abstract

Arterial trauma associated with hip fracture treatment is still a rare complication. We present a case in which an arterial injury was discovered during closed reduction and intramedullary nail fixation of a subtrochanteric hip fracture. The preoperative thigh circumference was increased due to severe swelling, and the vascular injury was located substantially proximal to the fracture and the instrumentation area. An interventional angiogram revealed a damaged vessel originating from one of the minor proximal branches of the right deep femoral artery while filling a 2 cm-sized pseudoaneurysm. Embolization was performed without further complications.

Keyword

Femoral artery; Pseudoaneurysm; Subtrochanteric fractures; Embolization

MeSH Terms

Aneurysm, False
Femoral Artery
Glycosaminoglycans
Hip
Hip Fractures
Nails
Thigh
Vascular System Injuries
Glycosaminoglycans

Figure

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  Fig. 1 (A, B) Preoperative radiographs; anteroposterior and translateral view showing subtrochanteric fracture with proximal migration of the femur shaft and deformed proximal fragment. Notice the anterior beak of the proximal fragment with severe angulation (arrow). Extensive calcifications are seen in the arteries.

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  Fig. 2 Clinical photograph of thigh swelling with knee flexion contracture. Notice the swelling of injured limb is more than twice the circumference of the contralateral limb.

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  Fig. 3 Computed tomographic angiogram showing the extravasation of contrast material from branch of deep femoral artery.

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  Fig. 4 (A) Digital subtraction angiography showing contrast extravasations originating from one of the minor proximal branch of right deep femoral artery, while filling a 2 cm sized pseudoaneurysm (arrow). (B) After embolization. Postembolization angiography demonstrated no additional extravasation of contrast medium.

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