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Iatrogenic tibial pseudoaneurysm following below-knee amputation
T J Bunt1, J M Malone, R R Karpman
1Department of Surgery, Maricopa Medical Center, Phoenix, Arizona 85010.
The American Surgeon
|September 1, 1990
Summary
Tibial vessel injury is a rare complication following lower extremity amputation. This case highlights acute pseudoaneurysm and arteriovenous fistula caused by unrecognized injury to posterior tibial vessels during fibular periosteal elevation.
Area of Science:
- Vascular Surgery
- Orthopedic Surgery
- Trauma Surgery
Background:
- Lower extremity amputation is a common surgical procedure.
- Proximity of tibial vessels to the fibula raises concern for potential injury during amputation.
- Reported complications of amputation typically do not include tibial vessel injury.
Observation:
- A case of acute pseudoaneurysm with an arteriovenous fistula involving the posterior tibial vessels is presented.
- The injury occurred following a lower extremity amputation.
- The etiology was unrecognized arterial and venous injury secondary to fibular periosteal elevation.
Findings:
- Fibular periosteal elevation during amputation can lead to unrecognized injury of the posterior tibial artery and vein.
- This injury can manifest as a pseudoaneurysm and arteriovenous fistula.
- The proximity of these vessels to the fibula makes them vulnerable during surgical manipulation.
Implications:
- Awareness of potential tibial vessel injury during fibular periosteal elevation is crucial for surgeons performing lower extremity amputations.
- Prompt diagnosis and management of pseudoaneurysms and arteriovenous fistulas are necessary to prevent complications.
- This case underscores the importance of meticulous surgical technique and intraoperative vigilance to avoid vascular complications.