股骨粗隆間骨折內固定術后并發股深動脈假性動脈瘤一例_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

 宋迪煜 , 張樹明 , 喬林 , 王奎友 , 劉志剛

第二炮兵總醫院骨科（北京，100088）;

Corresponding?author：

宋迪煜, Email: sondytt@yahoo.com

Keywords：

股骨粗隆間骨折; 假性動脈瘤; 骨折內固定; 并發癥

DOI：

10.7507/1002-1892.20150224

Video：

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目的總結1例股骨粗隆間骨折內固定術后并發股深動脈假性動脈瘤診治體會。方法 2011年10月收治1例摔傷致右側股骨粗隆間骨折的女性患者，年齡78歲。入院后采用股骨近端防旋髓內釘（proximal femoral nail antirotation，PFNA）行骨折復位內固定術。術后第9天出現患側大腿疼痛并逐漸加重，血紅蛋白降低。第13天B超檢查示右大腿前側包塊。急診行右下肢超選擇性血管造影術，示股深動脈第2穿支遠端假性動脈瘤形成。用彈簧圈行第2穿支動脈栓塞術。結果栓塞術后患側大腿疼痛明顯減輕，腫脹逐漸消退，順利出院。患者獲隨訪2年，右股骨粗隆間骨折完全愈合，患側髖關節功能Harris評分為優。結論股骨粗隆間骨折內固定術后如出現不明原因患側大腿疼痛、腫脹、血紅蛋白進行性下降等，應警惕假性動脈瘤的發生，行選擇性血管造影術明確并選擇相應治療方法。

Citation： 宋迪煜, 張樹明, 喬林, 王奎友, 劉志剛. 股骨粗隆間骨折內固定術后并發股深動脈假性動脈瘤一例. Chinese Journal of Reparative and Reconstructive Surgery, 2015, 29(8): 1047-1048. doi: 10.7507/1002-1892.20150224 Copy

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1. Ryzewicz M,Robinson M,McConnell J,et al.Vascular injury during fixation of an intertrochanteric hip fracture in a patient with severe atherosclerosis.A case report.J Bone Joint Surg (Am),2006,88(11):2483-2486.
2. Karanikas I,Lazarides M,Arvanitis D,et al.Iatrogenic arterial trauma associated with hip fracture surgery.Acta Chir Belg,1993,93(6):284-286.
3. Li XN,Luckeroth PD,Curry EJ,et al.Pseudoaneurysm of the profunda femoris artery following a long anterograde intramedullary nail for an unstable intertrochanteric hip fracture:A case report and review of the literature.Eur J Orthop Surg Traumatol,2011,21(4):293-299.
4. Chan WS,Kong SW,Sun KW,et al.Pseudoaneurysm and intramuscular haematoma after dynamic hip screw fixation for intertrochanteric femoral fracture:a case report.J Orthop Surg (Hong Kong),2010,18(2):244-247.
5. Cowley A,Williams D,Butler M,et al.Pseudo-aneurysm of the profunda femoris artery as a late complication of hip fracture in a patient with myelodysplasia.Ann R Coll Surg Engl,2007,89(7):W4-6.
6. Patelis N,Koutsoumpelis A,Papoutsis K,et al.Iatrogenic injury of profunda femoris artery branches after intertrochanteric hip screw fixation for intertrochanteric femoral fracture:a case report and literature review.Case Rep Vasc Med,2014,2014:694235.
7. Singh S,Arora S,Thora A,et al.Pseudoaneurysm of profunda femoris artery following dynamic hip screw fixation for intertrochanteric femoral fracture.Chin J Traumatol,2013,16(4):233-236.

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Chinese Journal of Reparative and Reconstructive Surgery

股骨粗隆間骨折內固定術后并發股深動脈假性動脈瘤一例

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