Late vascular injury following intertrochanteric fracture reduction with sliding hip screw.
A case involving late injuries to pelvic vessels caused by a sliding hip screw penetrating through the acetabulum has not been previously reported. We present the case of an 88-year-old man who presented with a retroperitoneal and extraperitoneal hematoma 4 months after open reduction and internal fixation of an intertrochanteric hip fracture. Surgical exploration showed a laceration of the left external iliac artery, which was repaired. However, the sliding hip screw was left in place. The patient's condition deteriorated, and he expired 2 days later. Postmortem examination revealed a laceration of the left internal iliac vein. Our calculations show that the compression screw utilized in the fixation may not have been properly engaged into the sliding screw.
Moreyra
Carlos E
CE
Orthopedic Institute at Mercy, Miami, FL 33133, USA.
Lavernia
Carlos J
CJ
Cooke
Christopher C
CC
D000058:Accidental Falls; D000368:Aged; D000369:Aged, 80 and over; D001860:Bone Plates; D001863:Bone Screws / Q000009:adverse effects*; D018450:Disease Progression; D004868:Equipment Failure; D017809:Fatal Outcome; D005548:Foreign-Body Migration / Q000000981:diagnostic imaging / Q000601:surgery*; D005594:Fracture Fixation, Intramedullary / Q000009:adverse effects* / Q000379:methods; D006406:Hematoma / Q000209:etiology* / Q000601:surgery; D006620:Hip Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007083:Iliac Artery / Q000293:injuries*; D008297:Male; D011859:Radiography; D012086:Reoperation; D018570:Risk Assessment; D013997:Time Factors