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      Nonunion of the tibial facture as a consequence of posterior tibial artery pseudoaneurysm

      case-report

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          Abstract

          Pseudoaneurysm of the posterior tibial artery (PTA) is uncommon, and they mainly occur following high-velocity trauma, open fractures and can be iatrogenic in nature. To the best of our knowledge, this is the first reported and successfully treated case of PTA pseudoaneurysm identified as a consequence of tibia fracture nonunion in an otherwise healthy young individual 6 months following the original incident with a novel intraoperative technique.

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          Delayed unions and nonunions of open tibial fractures. Correlation with arteriography results.

          E. Delgado, D Contreras, Emmanuel K Dickson … (1994)
          To investigate the importance of arterial integrity in tibial fracture healing, the authors retrospectively assessed prognosis as a function of arterial injury in a large series of tibial fracture patients. The records of 114 patients who were treated for an open fracture of the tibia at a San Francisco hospital between 1981 and 1991 were selected for review; in each case, the injury had been caused by a blunt trauma, and arteriography had been performed to evaluate a suspected arterial injury in the ipsilateral extremity. Sixty-two patients had had a normal arteriogram and 52 had demonstrated occlusion of one or two of the three arteries that supply the foot. The group of patients who had demonstrated arterial occlusion had a significantly greater incidence of delayed union or nonunion (24 of 52 compared with ten of 62) and notably more cases of osteomyelitis (nine of 52 compared with four of 62); when the patients with osteomyelitis are excluded, the difference between the groups is still significant. This study is the first that indicates that patients with open fractures of the tibia who demonstrate arterial occlusion in their ipsilateral extremity may be more prone to delayed union or nonunion. More vigilant follow-up evaluation may therefore be warranted in such patients to better anticipate the need for exchange rodding or bone grafting.
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            Endovascular treatment of a post-traumatic tibial pseudoaneurysm and arteriovenous fistula: case report and review of the literature.

            Rita Spirito, Piero Trabattoni, Giulio Pompilio … (2007)
            Here we report a rare case of a 74-year-old man with a pseudoaneurysm of the anterior tibial artery and a concomitant arteriovenous fistula (AVF). The patient was admitted because of increasing pain following the formation of a large mass located in the anterior mid-portion of the calf after a moderate non-penetrating blunt trauma. A polytetrafluoroethylene-covered stent was placed over the origin of the pseudoaneurysm, with complete exclusion of the pseudoaneurysm and disappearance of the AVF. One year after the procedure the mass had completely disappeared and the vascular anatomy of the calf is well preserved.
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              Anterior tibial artery pseudoaneurysm after ankle arthroscopy.

              D Mukherjee, S Cero, Helio Salgado … (1998)
              Arthroscopy of the ankle has dramatically expanded its role in diagnostic and therapeutic value afforded to the patient; however, it is not without complications. Although the majority of the complications described are neurological in origin, vascular injuries can occur. A case of a patient with normal coagulation parameters who underwent a purely diagnostic ankle arthroscopy and later developed a pseudoaneurysm of her distal anterior tibial artery is described. The pseudoaneurysm was resected without complications and early postoperative recovery has been uneventful.
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Surg Case Rep
                Journal ID (iso-abbrev): J Surg Case Rep
                Journal ID (publisher-id): jscr
                Journal ID (hwp): jscr
                Title: Journal of Surgical Case Reports
                Publisher: Oxford University Press
                ISSN (Electronic): 2042-8812
                Publication date Collection: November 2015
                Publication date (Electronic): 01 November 2015
                Volume: 2015
                Issue: 11
                Electronic Location Identifier: rjv138
                Affiliations
                [1 ]Department of Vascular and Endovascular Surgery
                [2 ]Department of Interventional Radiology
                [3 ]Department of Plastic Surgery
                [4 ]Department Trauma and Orthopedic Surgery, MId Essex Hospital Services NHS Trust, Broomfield Hospital, CM1 7ET, Essex, UK
                Author notes
                [* ]Correspondence address. Department of Vascular and Endovascular Surgery, Mid Essex Hospital Services NHS Trust, Broomfield Hospital, Chelmsford, Essex CM1 7ET, UK. Tel: +441245-514095; Fax: +441245-514491; E-mail: alikrdzadeh@ 123456gmail.com
                Article
                Publisher ID: rjv138
                DOI: 10.1093/jscr/rjv138
                PMC ID: 4628308
                PubMed ID: 26521160
                SO-VID: f65fb39e-cf0a-4f99-8f12-164c1da309e8
                Copyright © Published by Oxford University Press and JSCR Publishing Ltd. All rights reserved. © The Author 2015.
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com

                History
                Date received : 22 September 2015
                Date accepted : 7 October 2015
                Page count
                Pages: 3
                Categories
                Subject: Case Reports
                Subject: 0180

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