Hip Pelvis.  2013 Dec;25(4):297-300. 10.5371/hp.2013.25.4.297.

A Vessel Injury by Trocar of Closed Suction Drainage after Hip Hemiarthroplasty: A Case Report

• Moon KP
• Kang MS
• Kim KT
• Park WR
• Park WS

• KMID: 1808139
• DOI: http://doi.org/10.5371/hp.2013.25.4.297

Abstract

Vascular complication of hip arthroplasty is relatively rare, and usually involves iatrogenic injury or thrombus formation of main vessels. No case of vascular injury associated with closed suction drainage has been reported. The current report describes an injury of a branch from the lateral circumflex femoral artery caused by a trocar of closed suction drainage in a 72-year-old man who had been treated with bipolar hemiarthroplasty because of a femoral neck fracture. We report on this case with a review of the literature in order to avoid similar complications.

Keyword

Hip hemiarthroplasty; Vascular injury; Trocar

MeSH Terms

Aged
Arthroplasty
Femoral Artery
Femoral Neck Fractures
Hemiarthroplasty*
Hip*
Humans
Suction*
Surgical Instruments*
Thrombosis
Vascular System Injuries

Figure

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  Fig. 1 Postoperative X-ray shows the location of closed suction drainage system.

• 

  Fig. 2 The branches of lateral circumflex femoral artery. (A) The crest branch, (B) the branch to gluteus medius muscle, (C) the branch to tensor fascia lata, (D) the ascending branch, (E) the descending branch, (F) the lateral circumflex femoral artery. Arrow: puncture site by trocar.

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  Fig. 3 Aixal and coronal view of CT angiography, the arrows indicate ascending branch of lateral circumflex femoral artery and extravasation of contrast media.

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  Fig. 4 Intraoperative photograph, the arrow indicates dissected ascending branch of lateral femoral circumflex femoral artery.

Reference

1. Callaghan JJ, Rosenberg AG, Rubash HE. The adult hip. 2nd ed. Philadelphia: Lippincott Williams & Wilkins;2007. p. 1103–1104.

2. Bach CM, Steingruber IE, Ogon M, Maurer H, Nogler M, Wimmer C. Intrapelvic complications after total hip arthroplasty failure. Am J Surg. 2002; 183:75–79.

3. Nachbur B, Meyer RP, Verkkala K, Zürcher R. The mechanisms of severe arterial injury in surgery of the hip joint. Clin Orthop Relat Res. 1979; (141):122–133.

4. Holt BT, Parks NL, Engh GA, Lawrence JM. Comparison of closed-suction drainage and no drainage after primary total knee arthroplasty. Orthopedics. 1997; 20:1121–1124.

5. Sundaram RO, Parkinson RW. Closed suction drains do not increase the blood transfusion rates in patients undergoing total knee arthroplasty. Int Orthop. 2007; 31:613–616.

6. Beer KJ, Lombardi AV Jr, Mallory TH, Vaughn BK. The efficacy of suction drains after routine total joint arthroplasty. J Bone Joint Surg Am. 1991; 73:584–587.

7. Ovadia D, Luger E, Bickels J, Menachem A, Dekel S. Efficacy of closed wound drainage after total joint arthroplasty. A prospective randomized study. J Arthroplasty. 1997; 12:317–321.

8. Valdatta L, Tuinder S, Buoro M, Thione A, Faga A, Putz R. Lateral circumflex femoral arterial system and perforators of the anterolateral thigh flap: an anatomic study. Ann Plast Surg. 2002; 49:145–150.

9. Xu DC, Kong JM, Zhong SZ. The ascending branch of the lateral circumflex femoral artery. A new supply for vascularized iliac transplantation. Surg Radiol Anat. 1989; 11:263–264.