title: Rupture of the Deep Femoral Artery during Proximal Femoral Nailing Following an Intertrochanteric Fracture: A Case Report.
abstract: Recently, we experienced a case where the diagnosis and management of a deep femoral artery rupture was delayed. This vascular complication occurred during the insertion of a distal interlocking screw of a proximal femoral nail for the fixation of an intertrochanteric femur fracture. A 79-year-old male patient was diagnosed with a right intertrochanteric fracture after a fall. We fixed the fracture with a proximal femoral nail (Zimmer® Natural Nail™ System). One day after the procedure, the patient complained of pain and swelling on the anteromedial side of his middle thigh followed by hypotension, anemia and prolonged thigh swelling. Computed tomography angiography was performed 7 days after the procedure. We found a pseudoaneurysm of the perforating artery caused by injury to the deep femoral artery and an intramuscular hematoma in the anterior thigh muscle. We successfully treated the pseudoaneurysm using coil embolization. Throughout the management of intertrochanteric femoral fractures, it is important to be aware and monitor signs and symptoms related to the possibility of blood vessel damage. When a patient presents with swelling and pain on the middle thigh and/or unexplained anemia postoperatively, the possibility that these symptoms are caused by an injury to the femoral artery must be considered.
authors.affiliation: Department of Orthopedic Surgery, National Health Insurance Service Ilsan Hospital, Goyang, Korea.
authors.forename: Han Kook
authors.initials: HK
authors.lastname: Yoon
authors.affiliation: Department of Orthopedic Surgery, National Health Insurance Service Ilsan Hospital, Goyang, Korea.
authors.forename: Hyun Cheol
authors.initials: HC
authors.lastname: Oh
authors.affiliation: Department of Orthopedic Surgery, National Health Insurance Service Ilsan Hospital, Goyang, Korea.
authors.forename: Junyoung
authors.initials: J
authors.lastname: Park
authors.affiliation: Department of Orthopedic Surgery, National Health Insurance Service Ilsan Hospital, Goyang, Korea.
authors.forename: Choidog
authors.initials: C
authors.lastname: Oyunbat
authors.affiliation: Department of Diagnostic Radiology, National Health Insurance Service Ilsan Hospital, Goyang, Korea.
authors.forename: Taehwan
authors.initials: T
authors.lastname: Kim
keywords: Femoral artery rupture; Femur; Hip fractures; Proximal femoral nail; Pseudoaneurysm