scholarly journals Von Willebrand’s disease mimicking postoperative bleeding after tibial nailing for tibial shaft fracture

2021 ◽  
Vol 11 (3) ◽  
pp. 126-130
Author(s):  
Kadri Yildiz
Keyword(s):  
Rare Complication ◽  
Postoperative Bleeding ◽  
Previous History ◽  
Shaft Fracture ◽  
Tibial Shaft Fracture ◽  
Tibial Shaft ◽  
Von Willebrand's Disease ◽  
Von Willebrand’S Disease ◽  
Frequent Relapses ◽  
Von Willebrand

Von Willebrand’s disease (VWD), or von Willebrand’s syndrome, is a bleeding syndrome characterized by low plasma levels of von Willebrand factor (VWF). VWD is the most common inherited human bleeding disorder. Partial quantitative deficiency of serum VWF is responsible for the majority of VWD cases. The effect of VWF deficiency on orthopedic operations is not well documented in the current literature. VWD may cause persistent blee­ding during the operative and postoperative periods. In the majority of cases, VWD occurs as a single episode, but frequent relapses with chronicity can be seen in a small number of cases. We reported a case of a 22-year-old man with VWD operated with intramedullary nailing due to tibial shaft fracture. The patient had no previous history of surgery, and was unaware of his VWD. The purpose of this study is to report a rare complication of an orthopedic surgical procedure with postsurgical bleeding mimicking tibialis anterior arterial perforation. Orthopedic surgeons must be alert to the possibility of VWD due to postsurgical difficulties and persistent bleeding.

scholarly journals Proximal peroneal artery traumatic pseudoaneurysm following a compound proximal tibial shaft fracture managed with an external fixator: A case report

2019 ◽  
Vol 27 (1) ◽  
pp. 89-92
Author(s):  
Malinda Rasith Ileperuma ◽  
Badra Hewavithana
Keyword(s):  
External Fixator ◽  
Rare Complication ◽  
Shaft Fracture ◽  
Sudden Onset ◽  
Peroneal Artery ◽  
Tibial Shaft Fracture ◽  
Tibial Shaft ◽  
Artery Pseudoaneurysm ◽  
Initial Injury ◽  
High Index Of Suspicion

A case of post-traumatic proximal peroneal artery pseudoaneurysm following a proximal tibial shaft fracture, complicated by acute compartment syndrome, fixed using an external fixator, in a 22-year-old female is presented. She was investigated for sudden-onset bleeding from the external fixator pin site, 6 weeks after the initial injury, was anaemic and diagnosed with a pseudoaneurysm at lower limb angiography. Contrast leak from the site of pseudoaneurysm was noted and open surgery with ligation of the pseudoaneurysm was performed. This rare complication of a proximal tibial shaft fracture has to be considered in patients presenting with acute bleeding from the surgical site or from pin sites after a significant lag period and requires a high index of suspicion.

Nocardia Osteomyelitis: A Rare Complication After Intramedullary Nailing of a Closed Tibial Shaft Fracture

2009 ◽  
Vol 23 (3) ◽  
pp. 232-236 ◽  
Author(s):  
Todd Vander Heiden ◽  
Philip F Stahel ◽  
Sarah Clutter ◽  
Connie Price ◽  
Steven L Peterson ◽  
...  
Keyword(s):  
Intramedullary Nailing ◽  
Rare Complication ◽  
Shaft Fracture ◽  
Tibial Shaft Fracture ◽  
Tibial Shaft

scholarly journals Pseudoaneurysm of Anterior Tibial Artery following Tibial Nailing: A Case Report

2005 ◽  
Vol 13 (2) ◽  
pp. 186-189 ◽  
Author(s):  
D Inamdar ◽  
M Alagappan ◽  
L Shyam ◽  
S Devadoss ◽  
A Devadoss
Keyword(s):  
Intramedullary Nailing ◽  
Rare Complication ◽  
Shaft Fracture ◽  
Complete Relief ◽  
Anterior Tibial Artery ◽  
Tibial Shaft Fracture ◽  
Tibial Shaft ◽  
Proximal Fibula ◽  
Tibial Artery ◽  
Anterior Tibial

Interlocking nailing is a widely accepted and performed treatment for tibial shaft fractures. The addition of percutaneously placed transfixation screws increases the stabilisation provided by intramedullary nailing; however, the technical complexity associated with the procedure has introduced new potential complications. We report a pseudoaneurysm of the anterior tibial artery caused by a proximal interlocking screw after intramedullary nailing surgery to repair a tibial shaft fracture. The patient experienced complete relief of symptoms following removal of the nail and the screws, excision of the proximal fibula, resection of the pseudoaneurysm, and ligation of the anterior tibial artery. We recommend the oblique placement of the proximal interlocking screws to prevent this rare complication.

Further Studies on Aggregation of Platelet-Type von Willebrand’s Disease Platelets by Human von Willebrand Factor

1986 ◽  
Vol 55 (03) ◽  
pp. 338-341 ◽  
Author(s):  
H Takahashi ◽  
W Tatewaki ◽  
M Hanano ◽  
R Nagayama ◽  
A Shibata
Keyword(s):  
Von Willebrand Factor ◽  
Ricinus Communis ◽  
Divalent Cations ◽  
Peanut Agglutinin ◽  
Von Willebrand's Disease ◽  
Von Willebrand’S Disease ◽  
Ricinus Communis Agglutinin ◽  
Von Willebrand ◽  
Induced Aggregation ◽  
Willebrand Factor

SummaryPlatelet-type von Willebrand’s disease (vWD) is a bleeding disorder characterized by a heightened interaction between platelets and von Willebrand factor (vWF) as the result of an intrinsic platelet abnormality (probably in GPIb). Platelet aggregability was nearly normal in response to thrombin, wheat germ agglutinin and Ricinus communis agglutinin in this disorder. Unmodified platelets showed no aggregation upon the addition of peanut agglutinin. Partially purified human vWF induced little aggregation of washed patient platelets, but the aggregation was greatly enhanced in the presence of plasma devoid of vWF. Monoclonal antibodies directed against GPIb and GPIIb/IIIa as well as EDTA completely inhibited vWF-induced aggregation. These results indicate that human vWF induces aggregation of platelet-type vWD platelets in the presence of divalent cations and some plasma cofactor(s), and that both GPIb and GPIIb/IIIa are involved in this aggregation.

An Immunoradiometric Assay for Factor VIII Related Antigen (VIIIRAg) Using Two Monoclonal Antibodies-Comparison with Polyclonal Rabbit Antibodies for Use in von Willebrand’s Disease Diagnosis

1984 ◽  
Vol 52 (03) ◽  
pp. 250-252 ◽  
Author(s):  
Y Sultan ◽  
Ph Avner ◽  
P Maisonneuve ◽  
D Arnaud ◽  
Ch Jeanneau
Keyword(s):  
Monoclonal Antibodies ◽  
Structural Changes ◽  
Polyclonal Antibodies ◽  
Disease Diagnosis ◽  
Immunoradiometric Assay ◽  
Von Willebrand's Disease ◽  
Von Willebrand’S Disease ◽  
Structural Abnormalities ◽  
Antigenic Material ◽  
Von Willebrand

SummaryTwo monoclonal antibodies raised against FVIII/von Willebrand protein were used in an immunoradiometric assay (IRMA) to measure this antigen in normal plasma and plasma of patients with different forms of von Willebrand’s disease. The first antibody, an IgG1 was used to coat polystyrene tubes, the second one, an IgG2a, iodinated and used in the second step. Both antibodies inhibit ristocetin induced platelet agglutination and react strongly with platelets, megacaryocytes and endothelial cells. The IRMA test using these antibodies showed greater sensitivity than that using rabbit polyclonal anti VIIIRAg antibodies. A good correlation between the two tests was nevertheless found when VIIIRAg was measured in the majority of patient’s plasma. However 5 patients from 3 different families showed more antigenic material in the rabbit antibody IRMA than in the monoclonal antibody IRMA. It is suggested therefore that the monoclonal antibodies identify part of the VIIIR:Ag molecule showing structural abnormalities in these vWd patients, these structural changes remaining undetected by the polyclonal antibodies.

scholarly journals Studies of the pathophysiology of acquired von Willebrand's disease in seven patients with lymphoproliferative disorders or benign monoclonal gammopathies

Blood ◽  
1984 ◽  
Vol 64 (3) ◽  
pp. 614-621 ◽  
Author(s):  
PM Mannucci ◽  
R Lombardi ◽  
R Bader ◽  
MH Horellou ◽  
G Finazzi ◽  
...  
Keyword(s):  
Lymphoproliferative Disorders ◽  
Type I ◽  
Agarose Gel Electrophoresis ◽  
Von Willebrand's Disease ◽  
Von Willebrand’S Disease ◽  
Monoclonal Gammopathies ◽  
Von Willebrand ◽  
Willebrand Factor ◽  
Factor Antigen ◽  
Ristocetin Cofactor

Abstract In seven patients with acquired von Willebrand's disease (AvWD) associated with lymphoproliferative disorders or benign monoclonal gammopathies, the platelet contents of von Willebrand factor antigen and ristocetin cofactor (vWF:Ag and vWF:RiCof, respectively) were normal. All the multimers of vWF:Ag could be seen in the 1.6% SDS- agarose gel electrophoresis patterns of plasma and platelet lysates. Infusion of 1-deamino-8-D-arginine vasopressin (DDAVP) augmented plasma levels of vWF:Ag and vWF:RiCof of all patients and corrected prolonged bleeding times (BT). However, compared with patients with congenital vWD type I and comparable degrees of baseline abnormalities treated in the same way, vWF:Ag and vWF:RiCof were increased less and cleared more rapidly from plasma and the BT remained normal for a shorter period of time. These studies provide evidence that these AvWD patients have qualitatively normal vWF in plasma, but at lower concentrations, that vWF in platelets is normal both qualitatively and quantitatively, and that cellular vWF can be rapidly released into plasma by DDAVP to correct the hemostatic abnormalities. However, vWF is removed rapidly from plasma, making the correction more transient than in congenital vWD type I.

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