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股骨转子间骨折髓内钉固定术后股内侧旋动脉假性动脉瘤

Medial femoral circumflex artery pseudoaneurysm following intramedullary nailing for intertrochanteric fracture.

作者信息

Nguyen Arthur S, Only Arthur J, Onizuka Naoko, Switzer Julie A

机构信息

University of Minnesota Medical School, Minneapolis, MN, USA.

Department of Orthopaedic Surgery, Methodist Hospital, Saint Louis Park, MN, USA.

出版信息

Trauma Case Rep. 2021 Dec 9;37:100577. doi: 10.1016/j.tcr.2021.100577. eCollection 2022 Feb.

Abstract

CASE

We present the case of a 92-year-old woman who developed a medial femoral circumflex artery (MFCA) pseudoaneurysm intraoperatively while obtaining reduction during intramedullary nailing (IMN) for intertrochanteric fracture.

CONCLUSIONS

Pseudoaneurysms are rare vascular complications in hip fracture surgery. Early recognition of signs and symptoms of this phenomenon are essential for diagnosis and treatment. Close post-operative monitoring and serial hemoglobin should be considered for unexplained intra-operative bleeding. A low threshold for angiography should be entertained if active bleeding and clinical decompensation occur during instrumented percutaneous pertrochanteric fracture reduction. This patient underwent conventional angiography with successful coil embolization and exclusion of the MFCA pseudoaneurysm.

摘要

病例

我们报告一例92岁女性患者,其在股骨转子间骨折行髓内钉固定术(IMN)复位过程中,术中出现股内侧旋动脉(MFCA)假性动脉瘤。

结论

假性动脉瘤是髋部骨折手术中罕见的血管并发症。早期识别该现象的体征和症状对于诊断和治疗至关重要。对于不明原因的术中出血,应考虑术后密切监测和连续血红蛋白检测。如果在经皮转子间骨折复位器械操作过程中出现活动性出血和临床失代偿,应考虑较低的血管造影阈值。该患者接受了传统血管造影,并成功进行了弹簧圈栓塞,排除了MFCA假性动脉瘤。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b37/8715203/1cb73ff59244/gr1.jpg

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