Wan Raymond Chung Wai, Liu Wing Hong, Ng Raymond Wai Kit, Tso Chi Yin, Chow Simon Kwoon-Ho, Cheung Wing-Hoi, Tang Ning, Wong Ronald Man Yeung
Department of Orthopaedics & Traumatology, Prince of Wales Hospital, Hospital Authority, Hong Kong SAR, China.
Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China.
Trauma Case Rep. 2021 Aug 3;35:100517. doi: 10.1016/j.tcr.2021.100517. eCollection 2021 Oct.
Cement arterio-venogram is a rare event with cement extrusion into femoral nutrient vessels. In literature it is known to be benign with no significant clinical sequelae. It is postulated that it is due to high cement implantation pressure, that results in optimal cement filling quality. All previously reported cases were female patients, and it is thought to be a female only phenomenon due to the relatively narrow femoral canal leading to higher pressures during cementation. In this case series we report 3 cases different to existing literature. All 3 patients showed a cement arterio-venogram together with bone cement implantation syndrome and hypotension intraoperatively. It was also observed that during implantation the cement was of low viscosity. We postulate low cement viscosity during implantation with pressurization is also a contributing factor to these phenomena. This case series also demonstrates the first 2 male cases, showing this the even can occur in males too. The cement arteriovenogram is located at 41%-42% femur length which is within the 'third sixth' of the length of the femur. Good cementation techniques and prevention is also highlighted in this report.
骨水泥动静脉造影是一种罕见的情况，即骨水泥挤入股骨滋养血管。在文献中，它被认为是良性的，没有明显的临床后遗症。据推测，这是由于骨水泥植入压力过高，导致骨水泥填充质量最佳。所有先前报道的病例均为女性患者，由于股骨髓腔相对狭窄，在骨水泥注入过程中压力较高，因此被认为是仅发生于女性的现象。在本病例系列中，我们报告了3例与现有文献不同的病例。所有3例患者均出现骨水泥动静脉造影，同时术中出现骨水泥植入综合征和低血压。还观察到在植入过程中骨水泥的粘度较低。我们推测，植入过程中骨水泥粘度低并施加压力也是导致这些现象的一个因素。本病例系列还展示了首例2例男性病例，表明这种情况也可发生在男性身上。骨水泥动静脉造影位于股骨长度的41%-42%处，即在股骨长度的“第三个六分之一”范围内。本报告还强调了良好的骨水泥注入技术和预防措施。
