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External fixation and vascular damage: report of a case
A H Schuurman1, A H Broekhuizen, K E Bos
1Department of Surgery, University of Amsterdam, The Netherlands.
The Netherlands Journal of Surgery
|June 1, 1990
Summary
External fixation pin perforation of the anterior tibial artery is a rare complication. Direct arterial or venous damage is possible, requiring advanced reconstructive surgery like a free flap.
Area of Science:
- Orthopedic Surgery
- Vascular Surgery
- Trauma Management
Background:
- External fixation is a common orthopedic technique for fracture stabilization.
- Vascular injury is a known but infrequent complication associated with external fixation devices.
- Reconstructive surgery often relies on local tissue flaps for coverage.
Observation:
- A case of direct anterior tibial artery perforation by an external fixation pin is detailed.
- The injury necessitated a dorsal pedis free flap for heel and sole coverage due to compromised local tissue.
- Literature review indicated limited reports of vascular damage from external fixation pins.
Findings:
- Direct arterial and/or venous perforation by external fixation pins can occur.
- Secondary erosion is a common mechanism, but direct trauma is also possible.
- This complication may require complex reconstructive procedures.
Implications:
- Awareness of potential direct vascular injury from external fixation is crucial for orthopedic surgeons.
- Prompt recognition and appropriate surgical management are essential to prevent limb ischemia.
- Further investigation into the incidence and mechanisms of vascular injury is warranted.