股骨粗隆间骨折固定后继发于小粗隆碎片移位的迟发性股深动脉损伤1例报告及最新文献综述。

IF 1.6 4区 医学 Q4 GERIATRICS & GERONTOLOGY
Geriatric Orthopaedic Surgery & Rehabilitation Pub Date : 2025-06-17 eCollection Date: 2025-01-01 DOI:10.1177/21514593251351188
Slavko Čičak, Josip Kocur, Vedran Farkaš, Petra Čičak, Stjepan Ištvanić, Marko Lovrić, Marko Perić, Nenad Koruga, Tomislav Ištvanić
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引用次数: 0

摘要

背景:随着老年人口的增加和骨质疏松症的流行,老年股骨粗隆间脆性骨折对骨科实践提出了重大挑战。这些骨折对患者预后有显著影响,据报道30天内死亡率为13.3%,一年内死亡率为24.5%。病例介绍:本报告报告一例罕见的延迟性医源性股深动脉(DFA)损伤,原因是转子间骨折固定后小转子进行性移位。一名87岁女性患者术后33天出现明显的大腿肿胀和疼痛。影像学证实小转子碎片移位,导致DFA损伤和活动性出血。讨论:通过全面的文献回顾,我们探讨与股骨粗隆骨折固定相关的血管损伤的发生率、诊断方式和处理。我们强调术前识别明显移位的小转子碎片(bbb1cm)的重要性,因为它们明显增加了DFA损伤的风险。虽然关于常规碎片固定的争论仍在继续,但我们的病例表明,手术固定可能对大位移患者有益,以防止血管并发症。早期CT血管造影是一种重要的非侵入性诊断工具,可以及时发现和干预这些高危病例。结论:本病例强调了术后仔细监测和早期干预以优化患者预后的必要性。随着pff变得越来越普遍,进一步的研究对于改善老年骨科护理是必不可少的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Delayed Deep Femoral Artery Injury Secondary to Migrated Lesser Trochanter Fragment After Intertrochanteric Fracture Fixation: A Case Report and Updated Literature Review.

Background: With the increasing elderly population and prevalence of osteoporosis, geriatric intertrochanteric fragility fractures pose a major challenge to orthopedic practice. These fractures have a significant impact on patient outcomes, with a reported mortality rate of 13.3% within 30 days and 24.5% within one year.

Case presentation: This report presents a rare case of delayed iatrogenic deep femoral artery (DFA) injury due to progressive displacement of the lesser trochanter following intertrochanteric fracture fixation. An 87-year-old female patient developed significant thigh swelling and pain 33 days postoperatively. Imaging confirmed migration of the lesser trochanter fragment, leading to DFA injury and active bleeding.

Discussion: Through a comprehensive literature review, we explore the incidence, diagnostic modalities, and management of vascular injuries associated with pertrochanteric fracture fixation. We emphasize the importance of identifying significantly displaced lesser trochanter fragments (>1 cm) preoperatively, as they markedly increase the risk of DFA injury. While debate continues over routine fragment fixation, our case suggests that surgical fixation may be beneficial in selected patients with large displacements to prevent vascular complications. Early CT angiography is highlighted as a crucial non-invasive diagnostic tool for timely detection and intervention in these high-risk cases.

Conclusion: This case underscores the need for careful postoperative monitoring and early intervention to optimize patient outcomes. As PFFs become more prevalent, further research is essential to improve geriatric orthopedic care.

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来源期刊
CiteScore
3.00
自引率
0.00%
发文量
80
审稿时长
9 weeks
期刊介绍: Geriatric Orthopaedic Surgery & Rehabilitation (GOS) is an open access, peer-reviewed journal that provides clinical information concerning musculoskeletal conditions affecting the aging population. GOS focuses on care of geriatric orthopaedic patients and their subsequent rehabilitation. This journal is a member of the Committee on Publication Ethics (COPE).
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