Inamdar D, Alagappan M, Shyam L, Devadoss S, Devadoss A
Institute of Orthopaedic Research and Accident Surgery, Madurai, India.
J Orthop Surg (Hong Kong). 2005 Aug;13(2):186-9. doi: 10.1177/230949900501300216.
Interlocking nailing is a widely accepted and performed treatment for tibial shaft fractures. The addition of percutaneously placed transfixation screws increases the stabilisation provided by intramedullary nailing; however, the technical complexity associated with the procedure has introduced new potential complications. We report a pseudoaneurysm of the anterior tibial artery caused by a proximal interlocking screw after intramedullary nailing surgery to repair a tibial shaft fracture. The patient experienced complete relief of symptoms following removal of the nail and the screws, excision of the proximal fibula, resection of the pseudoaneurysm, and ligation of the anterior tibial artery. We recommend the oblique placement of the proximal interlocking screws to prevent this rare complication.
交锁髓内钉是治疗胫骨干骨折广泛接受且应用的方法。经皮置入的固定螺钉增加了髓内钉固定的稳定性;然而,该操作相关的技术复杂性带来了新的潜在并发症。我们报告了1例胫骨干骨折髓内钉手术后,近端交锁螺钉导致胫前动脉假性动脉瘤的病例。拔除髓内钉和螺钉、切除近端腓骨、切除假性动脉瘤并结扎胫前动脉后,患者症状完全缓解。我们建议近端交锁螺钉采用斜向置入以预防这种罕见并发症。