Vulvar necrosis after surgical treatment of femoral neck fracture: a case report and investigation of the mechanism of injury.
We report the case of a young patient, presenting with total bilateral vulvar necrosis after reduction of a femoral neck fracture. This report describes the management of this complication, its mechanism of injury and the associated means of prevention. We present an investigation of the vulvar vasculature in order to understand the mechanism of injury.The study of the vulvar vasculature rejects the anatomical hypothesis of selective damage to the internal and external arteries. Instead, it suggests intraoperative impingement of the terminal blood vessels caused by compression against the perineal post prompting discussion on the use of moulded countertraction posts during orthopaedic surgery.
Department of General and Gynaecological Surgery, CHU Rangueil, Toulouse - France.|Laboratory of Applied Anatomy, CHU Rangueil, Toulouse - France.
Elodie
E
Chantalat
Laboratory of Applied Anatomy, CHU Rangueil, Toulouse - France.
Guillaume
G
Debonnecaze
Department of Orthopaedic Surgery, CHU Pierre Paul Riquet, Toulouse - France.
Etienne
E
Cavaignac
Laboratory of Applied Anatomy, CHU Rangueil, Toulouse - France.
Patrick
P
Chaynes
Department of Gynaecological Surgery, CHU Paule de Viguier, Toulouse - France.
Fabien
F
Vidal
D000293:Adolescent; D005260:Female; D005265:Femoral Neck Fractures / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000009:adverse effects*; D006801:Humans; D009336:Necrosis / Q000209:etiology / Q000473:pathology / Q000628:therapy; D014844:Vulva / Q000473:pathology*