Proximal femoral fractures and vascular injuries in adults: Incidence, aetiology and outcomes

Barquet, Antonio; Gelink, Andrés; Giannoudis, Peter V.

doi:10.1016/j.injury.2015.10.021

Cited by 45 publications

(67 citation statements)

References 122 publications

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“…Barquet et al 4 showed that most vascular lesions are extrapelvic (91.20%) instead of intrapelvic (8.24%). In the extrapelvic group, the prevalence of lesions in the deep femoral artery and its branches was as high as 78.31%.…”

Section: Discussionmentioning

confidence: 99%

Fratura proximal do fêmur e lesão vascular em adultos – Relato de caso

et al. 2019

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ResumoComplicações vasculares no tratamento cirúrgico da fratura do quadril são raras. A depender da lesão arterial, pode ocorrer um grave sangramento intraoperatório ou formação de hematoma subagudo com desenvolvimento de pseudoaneurisma arterial. Na literatura, as complicações mais frequentes relatadas são a formação de grandes hematomas locais após osteossíntese com parafuso deslizante do quadril. O objetivo do presente relato foi demonstrar um caso de lesão arterial tardia após osteossíntese proximal do fêmur.

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Section: Discussionmentioning

confidence: 99%

Fratura proximal do fêmur e lesão vascular em adultos – Relato de caso

et al. 2019

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“…In this scenario, different types of vascular complications have been reported in medical literature, mainly in the form of case reports: vessel laceration, haemorrhage, vascular compression, intimal flap tear, pseudoaneurysm, arteriovenous aneurysm, arterial thromboembolism, and ligation [4][5][6][7][8][9][10][11][12][13][14]20].…”

Section: Discussionmentioning

confidence: 99%

The role of interventional radiology in the treatment of lower limb vascular injuries after orthopaedic surgery

Giurazza¹,

Corvino²,

Silvestre³

et al. 2019

Pol J Radiol

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Purpose: This paper focuses on the role of interventional radiology embolisations in a series of patients presenting with iatrogenic vascular injuries of the lower limbs following orthopaedic interventions. Material and methods:Fourteen patients (mean age: 64 years, range 23-90 years) were retrospectively analysed. Clinical presentation consisted of palpable pulsatile mass, pain, reduced lower limb motion, or visible haematoma; 11 patients had also anaemia (haemoglobin < 7 g/dl). Results:The time between orthopaedic surgery and embolisation ranged between 0 and 67 days (mean: 15 days). Injured arterial vessels were as follows: inferior gluteal artery (2), superficial external pudendal artery (2), deep femoral artery (1), lateral circumflex femoral artery (3), medial circumflex femoral artery (2), articular branch of descending genicular artery (1), perforating femoral arteries (3), posterior tibial recurrent artery (1), and anterior tibial artery (1). The typologies of vascular lesion were: pseudoaneurysm 57%, bleeding with extraluminal contrast agent blush of the terminal arterial segment 36%, and laceration and bleeding with extraluminal contrast agent blush of the arterial main trunk 7%. Embolising agents adopted were microcoils 57%, glue 14%, microplug 7%, particles 14%, and covered stent 7%. In all cases clinical and procedural technical successes were obtained (100%). Conclusions:For the management of vascular injuries occurring after different orthopaedic interventions of the lower limbs, endovascular embolisations have proven to be safe and effective; orthopaedic surgeons should be aware of the support that interventional radiology could provide in the case of iatrogenic vascular complications.

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“…The thigh anatomy demonstrated that the femoral arteries run anterior to the femur, separate into SFAs, DFAs, and PFAs, and then run posteromedial or posterior to the femur from the medial aspect [7]. According to previous studies, [7,9,17], the common screw insertion methods for PFF were completely or almost outside-to-in.…”

Section: Discussionmentioning

confidence: 99%

“…According to previous studies, [7,9,17], the common screw insertion methods for PFF were completely or almost outside-to-in. The femoral arteries in the medial aspect of the femur were in jeopardy from screw insertion or over-shot drill bit, which should never be underestimated.…”

Section: Discussionmentioning

confidence: 99%

“…The vascular injury of femoral arteries in PFF internal fixation is rare but potentially life- or limb-threatening [6]. Although achieving early diagnosis and prompt accurate treatment are necessary, there is no optimal diagnostic or therapeutic modality for vascular injury [7]. Hence, further management or prevention of vascular injury may need clinical attention.…”

Section: Introductionmentioning

confidence: 99%

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Relationship Between Femur and Femoral Arteries for Identifying Risk Factors for Vascular Injury

Sun

Fan

et al. 2017

Med Sci Monit

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BackgroundThis study aimed to identify risk factors for vascular injury in proximal femoral fracture through identifying frequency and distances between femur and femoral arteries with computed tomography angiography and 3-dimensional reconstruction.Material/MethodsIn a series of 400 participants, based on measurement results regarding the distribution of femoral arteries in the medial femur, the femoral portion covering that part was divided into levels A–E. The center region, margin region, and risky area in the medial femur were defined. The frequency of femoral arteries and interested shortest distance between the outer femur and superficial, deep, and perforating femoral arteries (SFAs, DFAs, and PFAs) in the center region, margin region, and risky area at each level were recorded.ResultsThere were 173 males and 227 females (average age: 63.61±19.18 years) in this study. The starting point and end point for femoral arteries in the medial femur were from 22.55±4.23% to 54.56±8.39% of the whole femur. The femoral arteries in the medial femur mainly were distributed at levels B (88.2%), C (65.9%), and D (40.6%). The femoral arteries in center regions in the risky area, most of which were DFAs and PFAs, were mainly concentrated at levels B (26.93%) and C (11.81%).ConclusionsThe mid-shaft level was the most risky level, and the DFAs and PFAs were easier to injure than the SFAs when performing internal fixation of proximal femoral fracture. We recommended that great attention be paid to drill and screw insertion around the mid-shaft level for prevention of iatrogenic vascular injury.

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Proximal femoral fractures and vascular injuries in adults: Incidence, aetiology and outcomes

Cited by 45 publications

References 122 publications

Fratura proximal do fêmur e lesão vascular em adultos – Relato de caso

Fratura proximal do fêmur e lesão vascular em adultos – Relato de caso

The role of interventional radiology in the treatment of lower limb vascular injuries after orthopaedic surgery

Relationship Between Femur and Femoral Arteries for Identifying Risk Factors for Vascular Injury

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