title: Occult internal iliac arterial injury identified during open reduction internal fixation of an acetabular fracture: a report of two cases.
abstract: We present two cases of occult internal iliac arterial injury identified during operative reduction of a widely displaced posterior column posterior wall acetabular fracture. This complication was not recognised until reduction of the column fracture. There were no preoperative signs or symptoms indicative of a vascular injury. These cases emphasise the heightened awareness one must have when treating widely displaced posterior column fractures of the acetabulum, especially those fractures with extension into the greater sciatic notch, as previously formed clot can become dislodged and hemostasis lost. We also present management options when this complication occurs. We believe any surgeon treating acetabular fractures should be aware of this serious and potentially fatal complication.
authors.affiliation: Harvard University, Department of Orthopaedics, Massachusetts General Hospital, Boston, MA, United States. Electronic address: George.Chaus@me.com.
authors.forename: George W
authors.initials: GW
authors.lastname: Chaus
authors.affiliation: Harvard University, Department of Orthopaedics, Massachusetts General Hospital, Boston, MA, United States.
authors.forename: Marilyn
authors.initials: M
authors.lastname: Heng
authors.affiliation: Harvard University, Department of Orthopaedics, Massachusetts General Hospital, Boston, MA, United States.
authors.forename: Raymond M
authors.initials: RM
authors.lastname: Smith
mesh_terms: D000077:Acetabulum / Q000000981:diagnostic imaging* / Q000293:injuries; D000369:Aged, 80 and over; D000792:Angiography; D004621:Embolization, Therapeutic / Q000379:methods*; D005593:Fracture Fixation, Internal / Q000379:methods*; D050723:Fractures, Bone / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D057772:Vascular System Injuries / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy
keywords: Acetabular fracture; Internal iliac artery; Vascular injury