Case Report
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World J Orthop. Jul 18, 2013; 4(3): 154-156
Published online Jul 18, 2013. doi: 10.5312/wjo.v4.i3.154
Profunda femoris artery pseudoaneurysm following revision for femoral shaft fracture nonunion
Federico Valli, Marco GA Teli, Marco Innocenti, Ruggero Vercelli, Domenico Prestamburgo
Federico Valli, Marco GA Teli, Marco Innocenti, Domenico Prestamburgo, Department of Orthopaedic Surgery, Civile Regional Hospital, 20025 Legnano, Italy
Ruggero Vercelli, Department of Diagnostic and Interventional Radiology, Niguarda Cà Granda Regional Hospital, 20162 Milano, Italy
Author contributions: Valli F and Innocenti M were the attending surgeons; Vercelli R was the attending interventional radiologist; Teli MGA and Prestamburgo D designed and wrote the report.
Correspondence to: Marco GA Teli, MD, Department of Orthopaedic Surgery, Civile Regional Hospital, Via Papa Giovanni Paolo II, 20025 Legnano, Italy. marcoteli@hotmail.com
Telephone: +39-331-449828 Fax: +39-331-449593
Received: March 11, 2013
Revised: April 15, 2013
Accepted: May 8, 2013
Published online: July 18, 2013
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, Pseudoaneurysm, Nonunion, Femoral shaft, Endovascular repair

Core tip: Femoral artery pseudoaneurysms (FAPs) are a reported possible complication of intramedullary nailing for acute femoral shaft fractures. In this report we describe the delayed occurrence of a FAP after revision surgery for femoral shaft nonunion, its diagnosis and management by endovascular repair and discuss the pertinent findings in the medical literature.