title: "Asymmetric scalloping of the regenerate": a radiological sign of pseudoaneurysm in distraction osteogenesis.
abstract: Pseudoaneurysm formation is an uncommon but well-recognised and important complication in limb reconstruction surgery. Postoperative diagnosis is usually clinical or an incidental finding. We present an 11-year-old girl, who underwent two-stage limb lengthening with a circular fixator, for a previously treated pseudoarthrosis of the tibia. During the lengthening plan, a concave defect was noted on one side of the regenerate, which was found to be due to extrinsic compression by a pseudoaneurysm. Normal regenerate formation was seen after selective embolisation of the pseudoaneurysm. This concave appearance on one side of the regenerate has previously been described secondary to a difference in stability on the two sides of the osteotomy, when a monolateral fixator is used, but not due to extrinsic compression by a pseudoaneurysm. The authors propose that this radiographic appearance of "asymmetrical scalloping" on one side of the regenerate may represent a radiological sign of a pseudoaneurysm formation and should provoke investigation for the same.
authors.affiliation: Registrar Trauma and Orthopaedic Surgery, Barnsley District General Hospital, Barnsley, South Yorkshire, UK.
authors.forename: J
authors.initials: J
authors.lastname: Fagg
authors.forename: A
authors.initials: A
authors.lastname: Gulihar
authors.forename: J A
authors.initials: JA
authors.lastname: Fernandes
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