title: Klippel-Trenaunay syndrome: a rare cause of disabling pain after a femoral fracture.
abstract: Klippel-Trenaunay syndrome (KTS) is characterized by a cutaneous vascular nevus of the involved extremity, as well as bone and soft tissue hypertrophy of the extremity and venous malformations. We present the case of a 52-year-old man with a femoral fracture and a history of haemangiomas, limb bone hypertrophy and varicosity. The patient was finally diagnosed with KTS and treated in mini-invasive surgery by endomedullary fracture nailing in general anaesthesia. Clinical management was particularly demanding, not only because of the need to monitor the risk of haemorrhage and thrombosis but also because of the onset of a rare picture of neuropathic pain with hyperalgesia and allodynia, never previously reported in patients affected by KTS, that required the administration of major opioid drugs. According to our knowledge, this is the second case of KTS managed for femoral fracture. Unlike the previous report in literature, in this case a severe disabling neuropathic pain complicated the clinical management.
authors.affiliation: Department of Neuroscience and Organs of Sense, Orthopedics Section, Faculty of Medicine and Surgery, General Hospital, University of Bari, Piazza Giulio Cesare 11, Bari, Italy. angelanotarnicola@yahoo.it
authors.forename: Angela
authors.initials: A
authors.lastname: Notarnicola
authors.forename: Vito
authors.initials: V
authors.lastname: Pesce
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Maccagnano
authors.forename: Giovanni
authors.initials: G
authors.lastname: Vicenti
authors.forename: Biagio
authors.initials: B
authors.lastname: Moretti
mesh_terms: D005264:Femoral Fractures / Q000150:complications*; D006801:Humans; D006930:Hyperalgesia / Q000209:etiology*; D007715:Klippel-Trenaunay-Weber Syndrome / Q000150:complications / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D009437:Neuralgia / Q000209:etiology*