Iatrogenic Injury of Profunda Femoris Artery Branches after Intertrochanteric Hip Screw Fixation for Intertrochanteric Femoral Fracture: A Case Report and Literature Review

Patelis, Nikolaos; Koutsoumpelis, Andreas; Papoutsis, Konstantinos; Kouvelos, George; Vergadis, Chrysovalantis; Mourikis, Anastasios; Georgopoulos, Sotiris

doi:10.1155/2014/694235

Cited by 26 publications

(32 citation statements)

References 8 publications

(6 reference statements)

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“…The perforating branches of the profunda femoris artery have numerous clinical implications. Examples include providing an important collateral circulation in atherosclerotic disease, being in danger of iatrogenic injury in surgical fixation of femoral fractures and providing a basis for reconstructive surgery and embolisation.…”

Section: Introductionmentioning

confidence: 99%

Perforating arteries of the thigh: An anatomical and radiological study

et al. 2016

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Section: Introductionmentioning

confidence: 99%

Perforating arteries of the thigh: An anatomical and radiological study

et al. 2016

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“…Injury to the SFA, deep femoral artery (DFA), or PA have been described as a result of broken sharp fragments or iatrogenic injuries such as external xation pins, plunging drill bits, medial plating, or cerclage wiring. These damages could give rise to immediate bleeding, late presented pseudoaneurysm, limb ischemia, or below knee amputation [1,5,[15][16][17].…”

Section: Resultsmentioning

confidence: 99%

Distances between popliteal vessels to the femur and anthropometric impacts on distal femoral fracture surgery outcome: a retrospective study

Chang

Lin

Chen

et al. 2020

Preprint

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Background:The proximity of the popliteal vessels in the distal femur may increase the risk of iatrogenic vascular injury during cerclage wiring. In this study, the closest location and distance of the popliteal vessels to the femur was examined using magnetic resonance imaging (MRI). The associations between anthropometric factors and the distance that would guide the placement of wires safely during surgery were also identified.Methods:We reviewed knee MRIs of 206 adults and recorded 1) the relation as well as the shortest horizontal distance (d-H) from the femoral cortex to the popliteal vessels in axial images and 2) the vertical distance (d-V) from the adductor tubercle to the axial level of d-H in coronal images. The effects of anthropometric factors (i.e., gender, age, body height, body weight, body mass index, thigh circumference, femoral length, and femoral width) on these distances were analysed.Results:The closet locations of popliteal vessels were at the posteromedial aspect of the femur. The d-H and d-V were 7.38 ± 3.22 mm, and 57.01 ± 11.14 mm, respectively, and were both shorter in women than in men (P < 0.001). Multivariate analysis identified thigh circumference and femoral length as the most influential factors for the d-H and d-V, respectively (P < 0.001). Linear regression demonstrated a strong positive linear correlation between the thigh circumference and the d-H and between the femoral length and the d-V (Pearson’s r = 0.891 and 0.806, respectively [P < 0.001]).Conclusions:The closet location and distance of the popliteal vessels to the femur provide useful information for wire placement during distal femoral fracture surgery while minimising the risk of vascular injury. Given that patients with smaller thigh circumference and shorter femoral length are more likely to have smaller d-H and shorter d-V, respectively, cautious measures should be taken in such cases.Trial registration:retrospectively registered

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“…Vascular injury is a serious condition and any vascular structure that adjacent to a migrated screw is at risk for injury. Although rare, migrated screws may damage femoral vascular tree [3,4]. Early diagnosis is crucial, since large hemorrhage may cause ischemia.…”

Section: Discussionmentioning

confidence: 99%

“…A screw may penetrate through the adjacent soft tissue in time. Vascular injury, as a consequence of orthopedic hardware migration, has been reported in the literature [3,4]. However, in these reports, the condition affects the elderly patients who had previous surgery for hip replacement or fracture.…”

Section: Introductionmentioning

confidence: 99%

Screw migration in a 14-year-old boy with hip osteotomy; a rare cause of upper thigh hematoma

Ünal

2016

Med Ultrason

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Soft tissue injury due to orthopedic hardware migration is an uncommon complication. However particularly patients who have routine physical therapy sessions for extremity contractures are at risk for vascular injury in the setting of migrated screws. Ultrasound is an efficient modality to evaluate migrated screws and adjacent soft tissue structures. As a consequence of repetitive trauma a migrated screw would eventually result in injury. Herein a case of upper thigh hematoma due to screw migration in a patient with hip osteotomy is reported.

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Iatrogenic Injury of Profunda Femoris Artery Branches after Intertrochanteric Hip Screw Fixation for Intertrochanteric Femoral Fracture: A Case Report and Literature Review

Cited by 26 publications

References 8 publications

Perforating arteries of the thigh: An anatomical and radiological study

Perforating arteries of the thigh: An anatomical and radiological study

Distances between popliteal vessels to the femur and anthropometric impacts on distal femoral fracture surgery outcome: a retrospective study

Screw migration in a 14-year-old boy with hip osteotomy; a rare cause of upper thigh hematoma

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