Encounters with pseudoaneurysms in orthopaedic practice.
Thirteen pseudoaneurysms are presented of which five were caused as a complication of pin/wire placement of external fixators (one conventional and four Ilizarov frames). The most common symptom was the presence of profuse persistent bleeding from either the wound or the pin/wire site. In nine patients the pseudoaneurysm was directly caused by a fracture or subsequent fracture stabilisation. Pre-operative evaluation included radiography, arteriography, Doppler and computed tomography (CT) angiography. Depending on the site and size of the pseudoaneurysm management consisted of either ligation, resection and end-to-end anastamosis/vein grafting, lateral suture, endoaneurysmorrhaphy or selective embolisation.A high index of suspicion needs to be maintained following penetrating injury in the vicinity of a major vessel, particularly in the presence of persisting symptoms. External fixators are widely used to treat complex orthopaedic problems. The procedure is technically demanding, requiring a sound knowledge of cross-sectional limb anatomy. Injudicious use may result in potentially life/limb threatening complication of pseudoaneurysm.
Dhal
A
A
Department of Orthopaedics, Maulana Azad Medical College, 110002, Delhi, India. adhal@bol.net.in
Chadha
M
M
Lal
H
H
Singh
T
T
Tyagi
S
S
D000293:Adolescent; D000328:Adult; D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D002648:Child; D016267:External Fixators / Q000009:adverse effects*; D005263:Femoral Artery / Q000000981:diagnostic imaging; D050723:Fractures, Bone / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D016896:Treatment Outcome; D014950:Wounds, Penetrating / Q000150:complications