目的 总结1例股骨粗隆间骨折内固定术后并发股深动脉假性动脉瘤诊治体会。
方法 2011年10月收治1例摔伤致右侧股骨粗隆间骨折的女性患者，年龄78岁。入院后采用股骨近端防旋髓内钉（proximal femoral nail antirotation，PFNA）行骨折复位内固定术。术后第9天出现患侧大腿疼痛并逐渐加重，血红蛋白降低。第13天B超检查示右大腿前侧包块。急诊行右下肢超选择性血管造影术，示股深动脉第2穿支远端假性动脉瘤形成。用弹簧圈行第2穿支动脉栓塞术。
结果 栓塞术后患侧大腿疼痛明显减轻，肿胀逐渐消退，顺利出院。患者获随访2年，右股骨粗隆间骨折完全愈合，患侧髋关节功能Harris评分为优。
结论 股骨粗隆间骨折内固定术后如出现不明原因患侧大腿疼痛、肿胀、血红蛋白进行性下降等，应警惕假性动脉瘤的发生，行选择性血管造影术明确并选择相应治疗方法。
Citation：
宋迪煜, 张树明, 乔林, 王奎友, 刘志刚. 股骨粗隆间骨折内固定术后并发股深动脉假性动脉瘤一例. Chinese Journal of Reparative and Reconstructive Surgery, 2015, 29(8): 1047-1048. doi: 10.7507/1002-1892.20150224
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Copyright © the editorial department of Chinese Journal of Reparative and Reconstructive Surgery of West China Medical Publisher. All rights reserved
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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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