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01-09-2017 | Original Paper

The incidence of life threatening iatrogenic vessel injury following closed or open reduction and internal fixation of intertrochanteric femoral factures

Authors: David Segal, Eyal Yaacobi, Niv Marom, Victor Feldman, Elhan Aliev, Ezequiel Palmanovich, Gabriel Bartal, Yaron S. Brin

Published in: International Orthopaedics | Issue 9/2017

Abstract

Aim of the study

Bleeding due to a vascular injury is a possible life-threatening complication of intertrochanteric femoral fracture internal fixation. Our goals were to find the current incidence of these events, and to describe the reasons, the presentation, and the treatment options.

Method

We conducted a retrospective record review of 1,469 patients who were operated upon at our institution due to AO31A femoral fractures from 2011 through 2015 and were treated with closed reduction and internal fixation.

Results

Three patients were diagnosed with iatrogenic vascular bleeding, which constitute an incidence of 0.2%. The vascular injuries were detected as deep femoral artery bleeding adjacent to the distal locking screws. The patients were treated with ultrasound guided thrombin injection, endovascular coil embolization or with no endovascular intervention.

Discussion

Vascular injuries are caused mainly by perforating a vessel while drilling the distal locking screw holes. A high level of suspicion and immediate imaging work-up are mandatory.

Conclusions

A vascular injury due to internal fixation of a proximal AO31A femoral fracture is a rare complication.

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Title: The incidence of life threatening iatrogenic vessel injury following closed or open reduction and internal fixation of intertrochanteric femoral factures
Authors: David Segal
Eyal Yaacobi
Niv Marom
Victor Feldman
Elhan Aliev
Ezequiel Palmanovich
Gabriel Bartal
Yaron S. Brin
Publication date: 01-09-2017
Publisher: Springer Berlin Heidelberg
Published in: International Orthopaedics / Issue 9/2017
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-017-3545-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The incidence of life threatening iatrogenic vessel injury following closed or open reduction and internal fixation of intertrochanteric femoral factures

Abstract

Aim of the study

Method

Results

Discussion

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Aim of the study

Method

Results

Discussion

Conclusions

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