Pseudoaneurysm of the superficial femoral artery. An unusual complication following rotationplasty.
A 21 year old man presented with pain and swelling around the right knee. Staging studies and open biopsy provided a diagnosis of malignant fibrous histiocytoma, stage II B. A wide local excision followed by prosthetic reconstruction was not possible because of extensive involvement of the quadriceps muscle with tumor. Therefore the patient underwent wide local excision of the tumor and rotationplasty, providing functionally a transtibial amputation. Postoperatively (Day 44) a critical ischaemia of the foot developed, and angiography revealed a pseudoaneurysm of the superficial femoral artery at the level of the tibial condyle. The patient underwent successful arterial reconstruction and the bones united. The etiology of this pseudoaneurysm appears to be related to the presence of the coiled superficial femoral artery abutting the medial tibial condyle flare. This complication may be prevented by ensuring that the condylar flare be contoured, and then an adequate cushion of soft tissue be interposed between artery and bone at this level.
Blewitt
N
N
University Department of Orthopaedics, Royal Victoria Infirmary, Newcastle-upon-Tyne, United Kingdom.
Pooley
J
J
Berridge
D
D
Chamberlain
J C
JC
D000328:Adult; D000671:Amputation, Surgical / Q000534:rehabilitation*; D000783:Aneurysm / Q000209:etiology*; D005263:Femoral Artery; D005266:Femoral Neoplasms / Q000601:surgery; D018219:Histiocytoma, Benign Fibrous / Q000601:surgery; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000209:etiology; D013977:Tibia / Q000637:transplantation*; D014182:Transplantation, Autologous / Q000379:methods*