Kim Ji Wan, Lee Jung Il, Park Ki Chul
Haeundae Paik Hospital, Inje University, Busan, Republic of Korea.
Hanyang University Guri Hospital, Guri, Republic of Korea.
Acta Orthop Traumatol Turc. 2017 May;51(3):266-269. doi: 10.1016/j.aott.2017.03.011. Epub 2017 Apr 28.
An 85-year-old woman developed severe swelling and pain in the proximal thigh after internal fixation of an intertrochanteric fracture of the femur with a hip nail. In order to identify the causes and determine the effective treatment, angiography was performed. The results of the angiography revealed a pseudoaneurysm of a branch of deep femoral artery. Endovascular embolization was used to treat the pseudoaneurysm. After reviewing all possible causes, we found a mistake in insertion of a guide wire for hip nail. Using intraoperative fluoroscopic images, we found the mal-positioned guide wire located posterior to trochanter on lateral view of hip. This case study reminds us that pseudoaneurysm can occur in a guide wire during hip nailing. Surgeons can avoid this complication with confirmation of lateral and anteroposterior view of hip.
一名85岁女性在使用髋部髓内钉对股骨转子间骨折进行内固定后，大腿近端出现严重肿胀和疼痛。为了明确病因并确定有效的治疗方法，进行了血管造影。血管造影结果显示股深动脉一分支存在假性动脉瘤。采用血管内栓塞治疗该假性动脉瘤。在回顾所有可能的病因后，我们发现髋部髓内钉导丝插入有误。通过术中透视图像，我们发现在髋关节侧位片上，导丝位置不当，位于转子后方。本病例研究提醒我们，髋部髓内钉置入过程中导丝可能会导致假性动脉瘤。外科医生可通过确认髋关节的侧位和前后位视图来避免这种并发症。
