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. 2013 Jul 18;4(3):154-6.
doi: 10.5312/wjo.v4.i3.154. Print 2013 Jul 18.

Profunda femoris artery pseudoaneurysm following revision for femoral shaft fracture nonunion

Federico Valli  1 , Marco Ga Teli, Marco Innocenti, Ruggero Vercelli, Domenico Prestamburgo
Affiliations

Profunda femoris artery pseudoaneurysm following revision for femoral shaft fracture nonunion

Federico Valli et al. World J Orthop. .

Abstract

Femoral artery pseudoaneurysms (FAPs) have been described following internal fixation of intertrocantheric, subtrocantheric and intracapsular femoral neck fractures as well as core decompression of the femoral head. The diagnosis of FAP is usually delayed because of non-specific clinical features like pain, haematoma, swelling, occasional fever and unexplained anaemia. Because of the insidious onset and of the possible delayed presentation of pseudoaneurysms, orthopaedic and trauma surgeons should be aware of this complication. We report a case of Profunda Femoris arterial branch pseudoaneurysm, diagnosed in a 40-year-old male 4 wk after revision with Kuntscher intramedullary nail of a femoral shaft nonunion. The diagnosis was achieved by computed tomography angiography and the lesion was effectively managed by endovascular repair. The specific literature and suggestions for treatment are discussed in the paper.

Keywords: Arterial injury; Endovascular repair; Femoral shaft; Nonunion; Pseudoaneurysm.

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Figures

Figure 1
Figure 1
X-ray appearance of pseudoaneurysm. A: Anteroposterior and lateral radiograph of femoral shaft nonunion 8 mo after interlocking IM nailing; B: An ovoid, soft tissue mass behind the fracture site is visible 1 mo after exchange nailing.
Figure 2
Figure 2
Computed tomography appearance of pseudoaneurysm. Computed tomographic angiogram showing pseudoaneurysm of profunda femoris artery (arrow).
Figure 3
Figure 3
Embolisation. Elective (microcatheter) right deep femoral angiography pictures showing the pseudoaneurysm adjacent to the fracture site. A: Before coil embolization; B: After coil embolization (digital subtraction angiography).
Figure 4
Figure 4
Fracture healing. Anteroposterior and lateral radiograph of the femoral shaft 6 mo from revision surgery, showing fracture union.
See this image and copyright information in PMC

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