Tonogai Ichiro, Matsuura Tetsuya, Iwame Toshiyuki, Wada Keizo, Takasago Tomoya, Goto Tomohiro, Hamada Daisuke, Kawatani Yohei, Fujimoto Eiki, Kitagawa Tetsuya, Takao Shyoichiro, Iwamoto Seiji, Yamanaka Moriaki, Harada Masafumi, Sairyo Koichi
Department of Orthopedics, Institute of Biomedical Science, Tokushima University Graduate School, Tokushima, Japan.
Department of Cardiovascular Surgery, Institute of Biomedical Science, Tokushima University Graduate School, Tokushima, Japan.
Case Rep Orthop. 2017;2017:2865971. doi: 10.1155/2017/2865971. Epub 2017 May 18.
Ankle arthroscopy carries a lower risk of vascular complications when standard anterolateral and anteromedial portals are used. However, the thickness of the fat pad at the anterior ankle affords little protection for the thin-walled anterior tibial artery, rendering it susceptible to indirect damage during procedures performed on the anterior ankle joint. To our knowledge, only 11 cases of pseudoaneurysm involving the anterior tibial artery after ankle arthroscopy have been described in the literature. Here we reported a rare case of a 19-year-old soccer player who presented with pseudoaneurysm of the anterior tibial artery following ankle arthroscopy using an ankle distraction method and underwent anastomosis for the anterior tibial artery injury. Excessive distraction of the ankle puts the neurovascular structures at greater risk for iatrogenic injury of the anterior tibial artery during ankle arthroscopy. Surgeons should look carefully for postoperative ankle swelling and pain after ankle arthroscopy.
当使用标准的前外侧和前内侧入路时，踝关节镜检查出现血管并发症的风险较低。然而，踝关节前方脂肪垫的厚度对薄壁的胫前动脉几乎没有保护作用，这使得它在踝关节前方关节手术过程中容易受到间接损伤。据我们所知，文献中仅描述了11例踝关节镜检查后累及胫前动脉的假性动脉瘤病例。在此，我们报告了一例罕见病例，一名19岁的足球运动员在使用踝关节撑开方法进行踝关节镜检查后出现胫前动脉假性动脉瘤，并接受了胫前动脉损伤吻合术。踝关节过度撑开使神经血管结构在踝关节镜检查期间发生胫前动脉医源性损伤的风险更高。外科医生在踝关节镜检查后应仔细观察踝关节术后肿胀和疼痛情况。
