Pseudoaneurysm as a Complication of Femur Fracture Fixation.

Abstract

Introduction: Hip fractures are within the most injuries coming to the emergency department, and one of the highest operations done in the trauma section of the orthopedics department. Within this, hip fractures treatment can vary depending on where the fracture is situated within the femur, either intracapsular that requires a hip hemiarthroplasty or extracapsular with require in situ fixation, with each of these methods or any surgical procedure there are risks that can happen, in this case report, we are highlighting a rare complication of a hip fixation and how it was managed.

Case report: An 89-year-old lady presented to our emergency department with a 6-week history of left thigh pain and swelling. She sustained a left hip fracture 8 weeks before this presentation for which she had an uneventful surgery. On examination her left thigh was swollen, there was no pitting edema and her pulses were intact. A Doppler ultrasound showed a large pseudoaneurysm arising from the profunda femoris artery. A computed tomography angiogram was subsequently performed to confirm the diagnosis. The patient had a successful embolization of the pseudoaneurysm. This was confirmed with ultrasound 24 h later, which showed no refilling of the pseudoaneurysm. The patient was discharged home in good condition.

Conclusion: Arterial vessel damage following hip fractures is very rare. It may be caused by the fracture itself or more commonly as a consequence of intertrochanteric fracture fixation. A high index of suspicion should be maintained as the symptoms can be non-specific and the diagnosis can be challenging.