External iliac artery thrombosis after open reduction of an acetabular fracture: a case report

Major arterial injury from open reduction and internal fixation of an acetabular fracture through an ilioinguinal approach is rare. Detection of a major intraoperative arterial injury is simple. Detection of a more occult injury leading to thrombosis is not. We report the third known case of thrombosis of the external iliac artery following open reduction and internal fixation of an anterior column fracture. This case is of particular interest because it highlights the ability of young patients to compensate for major vessel occlusion and still maintain a well-perfused foot. Heightened awareness of subtle side-to-side differences in pulses postoperatively may reveal that occult injury is a more common occurrence than previously appreciated.