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股骨干骨折不愈合翻修术后股深动脉假性动脉瘤

Profunda femoris artery pseudoaneurysm following revision for femoral shaft fracture nonunion.

作者信息

Valli Federico, Teli Marco Ga, Innocenti Marco, Vercelli Ruggero, Prestamburgo Domenico

机构信息

Federico Valli, Marco GA Teli, Marco Innocenti, Domenico Prestamburgo, Department of Orthopaedic Surgery, Civile Regional Hospital, 20025 Legnano, Italy.

出版信息

World J Orthop. 2013 Jul 18;4(3):154-6. doi: 10.5312/wjo.v4.i3.154.

Abstract

Femoral artery pseudoaneurysms (FAPs) have been described following internal fixation of intertrocantheric, subtrocantheric and intracapsular femoral neck fractures as well as core decompression of the femoral head. The diagnosis of FAP is usually delayed because of non-specific clinical features like pain, haematoma, swelling, occasional fever and unexplained anaemia. Because of the insidious onset and of the possible delayed presentation of pseudoaneurysms, orthopaedic and trauma surgeons should be aware of this complication. We report a case of Profunda Femoris arterial branch pseudoaneurysm, diagnosed in a 40-year-old male 4 wk after revision with Kuntscher intramedullary nail of a femoral shaft nonunion. The diagnosis was achieved by computed tomography angiography and the lesion was effectively managed by endovascular repair. The specific literature and suggestions for treatment are discussed in the paper.

摘要

股骨粗隆间、粗隆下及囊内股骨颈骨折内固定术后以及股骨头髓芯减压术后均有股动脉假性动脉瘤(FAP)的相关报道。FAP的诊断通常会延迟,因为其临床特征不具特异性,如疼痛、血肿、肿胀、偶尔发热以及不明原因的贫血。由于假性动脉瘤起病隐匿且可能出现延迟表现,骨科和创伤外科医生应了解这一并发症。我们报告一例股深动脉分支假性动脉瘤病例,该病例为一名40岁男性,在使用Kuntscher髓内钉翻修股骨干骨不连4周后确诊。通过计算机断层扫描血管造影术得以确诊,并通过血管内修复有效处理了该病变。本文讨论了具体文献及治疗建议。

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