Pseudo-aneurysm of the lateral circumflex femoral artery after femoral neck fracture – A case report

Abstract

Only one case of injury of the lateral circumflex femoral artery secondary to a femoral neck fracture has been reported. We present a second case of this rare injury. A 59-year-old gentleman fell from an embankment, from approximately two meters in height, while landscaping and landed onto his left side. He suffered immediate pain in his left hip and was unable to weight bear. X-ray demonstrated a Garden II left femoral neck fracture. Within 24 of the injury, he underwent percutaneous internal fixation of his left hip using partially threaded cannulated screws. Two days post operatively, the patient described pain in his groin. X-ray was satisfactory and the pain was attributed to the fracture and subsequent surgery. However, this pain persisted, worsened and warranted further investigation. A doppler ultrasound, followed by a CT angiogram, confirmed a pseudoaneurysm of the lateral circumflex femoral artery which was treated with embolisation by the vascular surgery service. This relieved the patient's discomfort immediately. This is the second reported case of pseudo-aneurysm of the lateral circumflex femoral artery secondary to a femoral neck fracture.

Late-Onset Hematoma Due to Bleeding of a Small Branch of the Lateral Circumflex Femoral Artery Following Proximal Femur Intramedullary Nailing

“…The literature review revealed only five cases with vascular injury of the lateral circumflex femoral artery. Four of them concern pseudoaneurysm formation after fixation of femoral neck fracture [ 8 - 11 ] and only one concerns an intertrochanteric fracture [ 12 ]. Vascular injury in the cases with femoral neck fracture was caused after the fracture fixation due to iatrogenic intervention, while in the intertrochanteric fracture case, the injury of the lateral circumflex femoral artery was caused by the lesser trochanter fragment.…”