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骨科医生的苦恼:股骨转子间骨折内固定术后股深动脉假性动脉瘤的延迟诊断:一例报告并文献复习

Misery of Orthopaedic Surgeon: Delayed Diagnosis of Pseudoaneurysm of Profunda Femoris Artery Following Fixation of Intertrochanteric Femoral Fracture: A Case Report and Review of Literature.

作者信息

Agrawal Prabhat, Das Saubhik, Kumar Naveen

机构信息

Department of Orthopaedics, All India Institute of Medical Sciences (AIIMS), Patna, India.

Department of Orthopaedics, Rajendra Institute of Medical Sciences (RIMS), Ranchi, India.

出版信息

J Orthop Case Rep. 2020 May-Jun;10(3):53-56. doi: 10.13107/jocr.2020.v10.i03.1746.

Abstract

INTRODUCTION

Pseudoaneurysm of profunda femoris artery is an uncommonly reported vascular mishap after orthopedic procedures around proximal femur. Diagnostic dilemma and resulting delay are quite common due to varied clinical presentations.

CASE PRESENTATION

Herein, we report a case of a 65-year-old lady who was diagnosed in our institution with pseudoaneurysm of profunda femoris artery 3 months after getting operated for intertrochanteric fracture of right femur in a private hospital. She started having gradually enlarging painful thigh swelling of the involved limb 1 month after operation. She also developed concurrent weakness, anemia, and received multiple blood transfusions before being referred to our institution. Diagnosis was clinched with duplex ultrasound imaging and subsequent digital subtraction angiography with coil embolization was performed. She made an uneventful and speedy recovery, and doing well till the last follow-up.

CONCLUSION

Timely diagnosis is paramount to avoid limb- and life-threatening sequelae; surgeons should keep strong vigil to administer the timely intervention. Various preventive strategies during fixation of intertrochanteric fracture should be deployed to keep this untoward entity in abeyance.

摘要

引言

股深动脉假性动脉瘤是股骨近端周围骨科手术后一种报道较少的血管并发症。由于临床表现多样,诊断困境及由此导致的延误颇为常见。

病例报告

在此,我们报告一例65岁女性病例,她在一家私立医院接受右股骨粗隆间骨折手术后3个月,在我院被诊断为股深动脉假性动脉瘤。术后1个月,她开始出现患侧大腿逐渐肿大且疼痛的症状。她还并发了虚弱和贫血,在转诊至我院之前接受了多次输血。通过双功超声成像确诊,随后进行了数字减影血管造影及弹簧圈栓塞术。她恢复顺利且迅速,直至最后一次随访情况良好。

结论

及时诊断对于避免危及肢体和生命的后遗症至关重要;外科医生应保持高度警惕以便及时进行干预。在股骨粗隆间骨折固定期间应采用各种预防策略以避免出现这种不良情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5262/8051565/59e50df1a7c0/JOCR-10-53-g001.jpg

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