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肱骨干骨折钢板固定术后罕见并发症 - 迟发性肱动脉假性动脉瘤 1 例报告并文献复习

A Unique Complication after a Routine Operation - Late Pseudoaneurysm of the Brachial Artery after Plate Fixation of Humeral Shaft Fracture. A Case Report and Review of the Literature.

机构信息

Military Medical Academy, Sofia, Bulgaria.

NI Pirogov University Hospital, Sofia, Bulgaria.

出版信息

Folia Med (Plovdiv). 2020 Sep 30;62(3):610-614. doi: 10.3897/folmed.62.e49215.

Abstract

We report an extremely rare case of an 82-year-old woman with pseudoaneurysm of the brachial artery developed 22 months after a plate osteosynthesis with angularly stable locking plates for the proximal humerus. The condition was initially misdiagnosed as a tumor by the attending physician, and the patient was referred to an oncological unit. The case was successfully managed by a multidisciplinary team consisting of orthopedic and vascular surgeons.An up-to-date review of the available literature is also provided. The pseudo-aneurysms of the axillary and the distal peripheral arteries of the upper limb are a rare but potentially dangerous complication because the thromboembolism could lead to gangrene and amputation of the extremity. Despite casuistic, they should be taken into consideration in the differential diagnosis after plate osteosynthesis. Proper operative technique and constant vigilance when orthopedic implants are used are of paramount importance, which is actually the emphasis of this report.

摘要

我们报告了一例极其罕见的病例,一名 82 岁女性在肱骨近端使用角稳定锁定钢板行钢板内固定术后 22 个月时发生肱动脉假性动脉瘤。最初,主治医生误诊为肿瘤,患者被转至肿瘤科。该病例由骨科和血管外科医生组成的多学科团队成功治疗。我们还对现有文献进行了最新综述。腋部和上肢远端周围动脉假性动脉瘤是一种罕见但潜在危险的并发症,因为血栓栓塞可导致肢体坏死和截肢。尽管是个案,但在钢板内固定术后的鉴别诊断中应考虑到这些情况。正确的手术技术和使用骨科植入物时的持续警惕至关重要,这实际上是本报告的重点。

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