An Uncommon Complication of Arteriovenous Fistula Following Intramedullary Nail Distal Locking – A Case Report

Introduction:An arterial pseudo aneurysm formation is an unusual complication following intramedullary nail distal locking screw insertion. During such surgical procedure, arterial laceration might damage the wall, allowing blood leakage into the soft- tissue surrounding. Only few records are available regarding such injuries. Case Report: A 19-year-old male diagnosed with femoral shaft fracture after a trauma event, was treated using Antegrade Long Intra-Medullary Nail with distal locking screw. Following post-operative serial blood count indicating a consistent decrease in his Haemoglobin levels, a Computed Tomography angiogram was performed and showed an arteriovenous fistula of the lateral superior geniculate artery. The artery was coiled, and haemoglobin levels were stabilized again. Conclusion: A distal interlocking screw should be carefully placed, including blunt dissection before the drilling and screw placement. In addition, blood counts were proved essential in routine. Keywords: Arteriovenous fistula, intramedullary nail distal locking, antegrade long intra-medullary nail.

Non-vascularized large free fibular bone graft in post- traumatic and infectious ulnar bone defect: a case report

<p>This reported case is about the successful union of an adult male, having open post traumatic infected nonunion of ulna with a bone loss of ulna around 11 cm. Difficult environment around gap nonunion makes the management more difficult for bone graft to stay there. Repeated debridement and skin courage played the key role in controlling the infection. A calculated risk of putting a non-vascular 12 cm autologous fibular graft fixed with plate and screws and supported with medullary nail was taken and a successful union achieved within 4.5 months. So nonvascular free can be a choice for critical bone defects nonunion in fore bones post traumatic one also.</p>