Pseudoaneurysm of superficial femoral artery in a closed femur fracture - A case report

Abstract

Background: Vascular injuries in simple close fractures are rare and low suspicion risk for primary surgeons. They include thrombus formation, hematomas, pseudoaneurysms, ischemic changes, and absent pulsations. These injuries can cause morbid sequelae, including compartment syndrome, reperfusion injury, exsanguination, and limb loss. Case presentation: Following a closed femoral shaft fracture, a 12-year-old boy came to us with a compromised superficial femoral artery (SFA). At the moment of fixing, there was no evidence of arterial involvement. He presented to the Out-patient Department (OPD) two weeks after the primary surgery with swelling at the fracture site. CT-Angiography was performed, and the swelling was diagnosed as a pseudoaneurysm of the superficial femoral artery, which was repaired using a Great Saphenous Vein (GSV) graft. Conclusion: These uncommon vascular injuries in closed fractures can be identified by a thorough clinical examination and specific diagnostic tests, and with prompt vascular repair, limb-threatening consequences are preventable. In a simple close femur fracture without suspicious signs in clinical findings, it's not a routine practice to check the vascular status by means of fancy and costly diagnostic tests.

Keywords

• Closed femur shaft fracture
• Fasciotomy
• Flexible intramedullary nail
• Great saphenous vein (GSV) graft
• Vascular injury superficial femoral artery