Johns Shane, Curtis William, Gehlert Rick
University of New Mexico School of Medicine, Albuquerque, NM.
Department of Orthopaedics & Rehabilitation, University of New Mexico School of Medicine, Albuquerque, NM.
Ochsner J. 2025 Spring;25(1):54-58. doi: 10.31486/toj.24.0058.
Nonunion of a distal femur fracture is a serious complication in which bone healing ceases or fails to resolve, often necessitating further surgical intervention. Poor blood supply and unstable fixation have been identified as contributing factors to osseous nonunion. In this case, we highlight a challenging femur fracture that achieved osseous union only after resolution of a superficial femoral artery occlusion via endarterectomy that improved blood flow to the fracture site.
A 54-year-old male was involved in a high-speed motor vehicle accident that resulted in a left distal femur fracture. The patient underwent multiple reconstructive procedures that were complicated by hardware failure and recurrent nonunion. Prior to the sixth reconstruction, a superficial femoral artery occlusion was discovered and addressed with endarterectomy. The sixth and final procedure resulted in osseous union and stable fixation of the femur fracture.
A missed superficial femoral artery occlusion likely contributed to the delay in achieving osseous union of a traumatic comminuted distal femur fracture.
股骨远端骨折不愈合是一种严重的并发症，即骨愈合停止或未能完成，常常需要进一步的手术干预。血供不佳和固定不稳定已被确定为导致骨不愈合的因素。在此病例中，我们重点介绍了一例具有挑战性的股骨骨折，该骨折仅在通过动脉内膜切除术解决股浅动脉闭塞并改善骨折部位的血流后才实现骨愈合。
一名54岁男性遭遇高速机动车事故，导致左股骨远端骨折。患者接受了多次重建手术，但均因内固定失败和反复不愈合而复杂化。在第六次重建手术前，发现了股浅动脉闭塞并通过动脉内膜切除术进行了处理。第六次也是最后一次手术实现了骨愈合和股骨骨折的稳定固定。
漏诊的股浅动脉闭塞可能导致创伤性粉碎性股骨远端骨折骨愈合延迟。
