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全髋关节置换术后股总动脉内膜损伤。一例报告及文献复习。

Common femoral artery intimal injury following total hip replacement. A case report and literature review.

机构信息

Orthopaedics and Traumatology Department, Henri Mondor Hospital, Assistance Publique-Hôpitaux de Paris, Créteil Faculty of Medicine (Paris XII), 51, avenue Maréchal-de-Lattre-de-Tassigny, 94010 Créteil cedex, France.

出版信息

Orthop Traumatol Surg Res. 2009 Apr;95(2):154-8. doi: 10.1016/j.otsr.2008.11.002. Epub 2009 Mar 21.

Abstract

Vascular injuries diagnosed during the course of total hip arthroplasty (THA) implantations are rare. They must be constantly feared as they sometimes put at risk the vital and functional prognosis of the operated limb. We report the case of a common femoral artery injury diagnosed by arteriography within two days of THA replacement in the presence of atypical symptoms. The vascular damage was caused by an arterial lesion resulting from positioning a retractor on the anterior wall of the acetabulum. A literature review on the topic of vascular complications arising after THA made us aware of multiple possible mechanisms and clinical presentations relating to such complications while identifying specific risk factors in THA replacement cases. Acetabular revision constitutes a major risk situation. Most of these vascular complications may be better prevented or more efficiently treated by thorough preoperative assessment and careful postoperative monitoring.

摘要

在全髋关节置换术(THA)植入过程中诊断出的血管损伤很少见。必须时刻警惕这些损伤,因为它们有时会危及手术肢体的生命和功能预后。我们报告了一例在 THA 置换后两天内通过血管造影诊断出的股动脉损伤病例,该病例存在非典型症状。血管损伤是由髋臼前壁放置牵开器引起的动脉病变所致。对 THA 后血管并发症的相关文献进行回顾,使我们了解到多种可能的机制和临床表现,并确定了 THA 置换病例中的特定危险因素。髋臼翻修构成了一个主要的危险情况。通过彻底的术前评估和仔细的术后监测,可以更好地预防或更有效地治疗大多数这些血管并发症。

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