Hanson Cameron G, Hanson Logan F
College of Osteopathic Medicine, Kansas City University of Medicine and Biosciences, Kansas City, MO 64106, United States.
Department of Orthopaedic Surgery, Beaumont Health, Farmington Hills, MI 48336, United States.
J Clin Orthop Trauma. 2017 Nov;8(Suppl 2):S49-S51. doi: 10.1016/j.jcot.2017.09.008. Epub 2017 Sep 21.
Tibial fractures are a commonly seen injury in orthopedic surgery. Intramedullary nailing is considered the standard of care, as complications are rare. Those of a vascular nature, including iatrogenically induced pseudoaneurysms of the tibial artery have been previously described in the literature, however each reported case has required surgical repair. In the current case, we describe a repair of a tibial artery branch pseudoaneurysm, after direct contact with an interlocking screw from tibial intramedullary nailing, via ultrasound-guided thrombin injection. To the authors' knowledge, this is the first reported case of a tibial artery pseudoaneurysm repaired non-surgically. This adds support to the promising literature on non-invasive repair of orthopedically related pseudoaneurysms.
胫骨骨折是骨科手术中常见的损伤。髓内钉固定被认为是标准的治疗方法,因为并发症很少见。血管性并发症,包括医源性导致的胫动脉假性动脉瘤,此前在文献中已有描述,但每例报告病例均需手术修复。在本病例中,我们描述了一例胫动脉分支假性动脉瘤的修复,该假性动脉瘤是在胫骨髓内钉固定时与一枚交锁螺钉直接接触后形成的,通过超声引导下注射凝血酶进行修复。据作者所知,这是首例非手术修复胫动脉假性动脉瘤的报告病例。这为有关骨科相关假性动脉瘤非侵入性修复的前景广阔的文献提供了支持。