Although vascular injuries associated with femoral intertrochanteric fractures have been reported infrequently, bleeding due to vascular injury can lead to severe complications that can be potentially life and limb-threatening. The authors report a case of an injury of the ascending branch of the lateral femoral convolutional artery in a patient who underwent surgical treatment for a femoral intertrochanteric fracture. Vascular injury occurred due to the sharp margin of displaced lesser trochanter five weeks after surgery. Percutaneous transcatheter embolization was done and improved without additional complications. Therefore, the surgeons need to be aware of possible associated vascular injuries caused by displaced lesser trochanter fragments in femoral intertrochanteric fractures.
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Delayed Deep Femoral Artery Injury Secondary to Migrated Lesser Trochanter Fragment After Intertrochanteric Fracture Fixation: A Case Report and Updated Literature Review Slavko Čičak, Josip Kocur, Vedran Farkaš, Petra Čičak, Stjepan Ištvanić, Marko Lovrić, Marko Perić, Nenad Koruga, Tomislav Ištvanić Geriatric Orthopaedic Surgery & Rehabilitation.2025;[Epub] CrossRef
Vascular injuries combined with long bone fractures have been infrequent and difficult to manage. Despite of recent advancement in the vacular repalr and fixation of fracutres, it is not easy to save the limb. In order to identify the factor associated with amputation or salvage of the affected limb, a retrospective study of 14 patients whose injured vessels were repaired primarily at the time of bone fixation was perfomed. The ischemic time, the degree of soft tissue or bone injury and the method of treatment were evaluated with relation to the limb salvage, 4(28.6%) of that 14 long bone fractures needed secondary amputation due to a vascular insufficiency. In 3 of 4 fractures, in which vascular repair were delayed over 24 hours, afftected limbs were amputated later. Thus, the ischemnic time was determined as an important factor for limb salvage after the vascular injury associated with the long bone fracture(p<0.05). However, the dogree of the soft tissue of bone injury and the method of treatment were not correlated with the limb salvage.