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Iatrogenic arterial trauma associated with hip fracture surgery
I Karanikas1, M Lazarides, D Arvanitis
1Department of Vascular Surgery, Athens General Hospital, Greece.
Insights
Iatrogenic arterial injuries during hip fracture surgery are rare, occurring in 0.21% of cases. Prompt diagnosis and surgical treatment are crucial for favorable outcomes in these serious complications.
Area of Science:
- Orthopedic Surgery
- Vascular Surgery
- Trauma Management
Background:
- Hip fractures are common, necessitating surgical intervention.
- Surgical correction of hip fractures carries inherent risks, including vascular complications.
Purpose of the Study:
- To determine the incidence and characteristics of iatrogenic arterial injuries during hip fracture surgery.
- To highlight the mechanisms, clinical presentations, and management of these injuries.
Main Methods:
- Retrospective review of 1417 patients undergoing surgical treatment for hip fractures over a 5-year period.
- Analysis of cases with iatrogenic arterial injuries, including mechanism, affected artery, clinical findings, and treatment.
Main Results:
- Three cases (0.21% incidence) of iatrogenic arterial injury were identified.
- Injuries involved the profunda femoral artery (2 cases) and common femoral artery (1 case).
- Mechanisms included protruding screws, bone fragments, and external pressure from avulsed bone fragments.
Conclusions:
- Iatrogenic arterial injuries are infrequent but significant complications in hip fracture surgery.
- Early diagnosis and prompt surgical intervention are essential for successful management and patient outcomes.
Abstract:
During a 5 year period, 1417 patients with various types of hip fractures were surgically treated. Three cases of iatrogenic arterial injuries occurred during the correction procedures, giving an incidence of 0.21%. In 2 patients the profunda femoral and in one the common femoral artery were involved. The mechanisms of injury were: a protruding screw, beyond the medial border of the femur in the first patient, arterial tear, due to bone speculae in the second and external pressure to the artery from an avulsed lesser trochanter in the third. The clinical findings were false aneurysms in two and distal ischaemia in the third patient. All patients were surgically treated. Early diagnosis of this type of injuries is the cornerstone for a good outcome.