scholarly journals Anterior tibialis artery pseudoaneurysm after minimally invasive plate osteosynthesis in the proximal tibia: a case report

2020 ◽  
Vol 2020 (8) ◽  
Author(s):  
David Beaton Comulada ◽  
Saul Hernández-Rodríguez ◽  
Lenny Rivera ◽  
Charles Zierenberg ◽  
Luis Lojo-Sojo
Keyword(s):  
Minimally Invasive ◽  
Proximal Tibia ◽  
Plate Osteosynthesis ◽  
Duplex Ultrasound ◽  
High Energy ◽  
Anterior Tibial Artery ◽  
Minimally Invasive Plate Osteosynthesis ◽  
Artery Pseudoaneurysm ◽  
Anterior Tibial ◽  
The Right

Abstract Tibial plateau fractures are common fractures associated with high-energy trauma. The treatment of these fractures remains a challenge today. Recent management of fractures has moved from open surgery toward minimally invasive surgery to reduce complications and improve functional outcomes. Nevertheless, such a minimalistic approach makes visualization of neurovascular structures difficult, placing them at risk. We report the case of a 39-year-old male who developed a pseudoaneurysm of the anterior tibial artery following minimally invasive plate osteosynthesis of the right proximal tibia. Diagnosis was made through noninvasive duplex ultrasound and was referred to endovascular service. Understanding of the anatomy of the surgical site is vital to minimize complications. In addition, proper postsurgical patient evaluation is important to monitor the insurgence of such complications.

Clinical application of the anterolateral thigh free flap in high energy injuries of the lower extremity

2021 ◽  
Vol 9 (4) ◽  
pp. 1192
Author(s):  
Del Carmen-Ortega Ignacio ◽  
Cahuana-Quispe Alberto Ignacio ◽  
Jaimes-Duran Edwing Michel ◽  
Soulé-Martínez Christian Enrique
Keyword(s):  
Lower Extremity ◽  
Free Flap ◽  
Donor Site ◽  
High Energy ◽  
Road Accident ◽  
Anterior Tibial Artery ◽  
Osteosynthesis Material ◽  
Anterior Tibial ◽  
End To End ◽  
The Right

One of the recurring problems in plastic and reconstructive surgery is the loss of tissues of the lower extremities as a result of high-energy injuries. The difficulty of this reconstruction lies in the need for a sufficiently suitable and resistant tissue to allow this restoration. The thigh-free anterolateral flap, since its description in 1984, has great versatility for complex or extensive lower extremity reconstructions. We presented the case of a 37-year-old male patient who had a high-energy road accident on a bicycle, impacting a moving vehicle causing a multi fragmented fracture of the right proximal tibia AO 41 C2.2/Schatzker V. He was treated surgically with material from osteosynthesis and iliac crest graft. It is complicated by infection of the surgical wound, exposure of osteosynthesis material and absence of skin covering. Reconstruction of the upper third of the right leg was performed with a thigh-free anterolateral free flap with 2 end-to-end venous anastomoses from the flap to anterior tibial veins, and 1 end-to-end anastomosis from perforating artery to anterior tibial artery, with no associated complications. The thigh-free anterolateral free flap is a versatile and reliable mechanism for the reconstructive surgeon, as it provides excellent coverage for complex lower extremity wounds as well as low donor site morbidity. Outpatient follow-up with adequate clinical evolution was done. 

scholarly journals Iatrogenic Anterior Tibial Artery Pseudoaneurysm – A Rare Case Report

2021 ◽  
Vol 11 (7) ◽  
Author(s):  
Nishant D Goyal ◽  
Vinay Kumar Gautam ◽  
Vijay M Panchnadikar ◽  
Madhan Jeyaraman ◽  
Nikhil Valsangka ◽  
...  
Keyword(s):  
Case Report ◽  
Shaft Fracture ◽  
Anterior Tibial Artery ◽  
Artery Pseudoaneurysm ◽  
Tibia Shaft Fracture ◽  
Tibial Artery ◽  
Anterior Tibial ◽  
Pseudo Aneurysm ◽  
The Right ◽  
Tibia Shaft

Introduction: Interlocking tibia nail fixation for tibia shaft fracture treatment is one of the most commonest procedures performed in orthopedic trauma practices. We report one such case of a rare complication of anterior tibial artery (ATA) pseudo-aneurysm caused by the proximal coronal locking bolt performed by an unusual entry from lateral to medial side during shaft of tibia fracture fixation. Case Report: A 86- years old female sustained a road traffic accident and was diagnosed with a closed tibia shaft fracture of the right leg for which she underwent intramedullary interlocking nail IMIL nailing elsewhere. She presented to us three 3 weeks after primary surgery with persistent pain and swelling in the right leg proximally. We investigated and diagnosed her as having a pseudoaneurysm of the Anterior Tibial Artery on color Doppler and magnetic resonance imaging (MRI) angiography. The pseudoaneurysm of ATA was clipped without any complications. To avoid the rupture of the pseudoaneurysm during manipulation of nail and bolts, their positions were not changed as they were supporting the fracture well and the fracture was also not united at that time. Conclusion: Though Although interlocking nailing of tibia shaft fracture is a commonly performed procedure, it can lead to disastrous vascular complications if the procedure is not performed with utmost care. ATA injury by proximal locking bolts of the tibia nail mandates the need for reconsideration of the nail design with better screw hole positions. We recommend preferring standard AO manual instructions for proximal tibia locking bolt direction. Keywords: Pseudo-aneurysm, tibia nail, locking bolt, anterior tibial artery.

scholarly journals Unusual diagnosis in a patient with minor ankle trauma

CJEM ◽  
2016 ◽  
Vol 19 (06) ◽  
pp. 492-496
Author(s):  
Zoë Piggott ◽  
Donna Clark
Keyword(s):  
Early Identification ◽  
Severe Pain ◽  
Duplex Ultrasound ◽  
Sudden Onset ◽  
Anterior Tibial Artery ◽  
Artery Pseudoaneurysm ◽  
Anterior Tibial ◽  
Ankle Trauma ◽  
One Year ◽  
Definitive Management

AbstractWe present the case of a 23 year-old male who sustained an anterior tibial artery pseudoaneurysm after an apparently innocuous soccer injury. The patient presented with sudden onset severe pain and swelling one week after the injury. The diagnosis was made using duplex ultrasound, and confirmed with CT angiography. Definitive management consisted of endovascular platinum microcoiling. One year later, the patient is asymptomatic and remains active. A review of the epidemiology, diagnosis, and treatment of arterial pseudoaneurysm is presented. Bedside ultrasound in the emergency department may be a useful adjunct in the early identification of pseudoaneurysms.

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