Encounters with pseudoaneurysms in orthopaedic practice

Injury. 2001 Dec;32(10):771-8. doi: 10.1016/s0020-1383(01)00094-8.

Abstract

Thirteen pseudoaneurysms are presented of which five were caused as a complication of pin/wire placement of external fixators (one conventional and four Ilizarov frames). The most common symptom was the presence of profuse persistent bleeding from either the wound or the pin/wire site. In nine patients the pseudoaneurysm was directly caused by a fracture or subsequent fracture stabilisation. Pre-operative evaluation included radiography, arteriography, Doppler and computed tomography (CT) angiography. Depending on the site and size of the pseudoaneurysm management consisted of either ligation, resection and end-to-end anastamosis/vein grafting, lateral suture, endoaneurysmorrhaphy or selective embolisation.A high index of suspicion needs to be maintained following penetrating injury in the vicinity of a major vessel, particularly in the presence of persisting symptoms. External fixators are widely used to treat complex orthopaedic problems. The procedure is technically demanding, requiring a sound knowledge of cross-sectional limb anatomy. Injudicious use may result in potentially life/limb threatening complication of pseudoaneurysm.

MeSH terms

  • Adolescent
  • Adult
  • Aneurysm, False / diagnostic imaging
  • Aneurysm, False / etiology*
  • Aneurysm, False / therapy
  • Child
  • External Fixators / adverse effects*
  • Femoral Artery / diagnostic imaging
  • Fractures, Bone / complications*
  • Humans
  • Male
  • Middle Aged
  • Radiography
  • Treatment Outcome
  • Wounds, Penetrating / complications