Iatrogenic arterial trauma associated with hip joint surgery: an overview

Four cases of iatrogenic arterial injuries following hip surgery are reported. An overview of the literature revealed 122 additional cases. In 93 (74%) of these cases the arterial damage occurred following total hip replacement, 27 (21%) were related to hip fracture correction and six cases complicated other hip surgery procedures. Revisional hip surgery was found to be a definite risk factor. Injuries associated with hip replacement differ significantly in various characteristics of those associated with hip fracture correction. There was a 9% mortality and a 17% permanent disability rate in patients with arterial trauma following total hip replacement. In this group a significantly higher permanent disability rate was noticed in patients who first presented with ischaemia (p less than 0.05). No relationship between the location and mechanism of injury and the outcome was found. Mortality and permanent disability rates of 4% and 11%, respectively, were noticed in patients with injuries related to hip fracture correction.