Pseudoaneurysm of the anterior tibial artery following an ankle sprain: a case report of an uncommon ankle trauma with review of the literature

A tibioperoneal trunk mycotic pseudoaneurysm successfully treated with ligation

We present the case of a 68-year-old man with a tibioperoneal trunk mycotic pseudoaneurysm, a rarity in the modern age of antibiotics. We describe the patient's hospitalizations and workups that ultimately led to this diagnosis and our management with open ligation without bypass. This case highlights the importance of combining a thorough history and physical examination with laboratory and imaging data while keeping in mind a broad differential diagnosis.

Ruptured Pseudoaneurysm of the Lateral Plantar Artery After Tibiotalocalcaneal Fusion With Retrograde Nail-A Rare Complication

We report a rare presentation of a ruptured pseudoaneurysm of the lateral plantar artery following tibiotalocalcaneal fusion with a retrograde nail at 1 month after the index surgery. Although case reports of pseudoaneurysms of larger arteries such as the anterior tibial artery and posterior tibial artery after ankle surgery (e.g., ankle arthroscopy, implant removal, Ilizarov application) have been reported, we report a rare complication of a pseudoaneurysm of the lateral plantar artery. We discuss the anatomic considerations of the lateral plantar artery in the foot and the entry point of the retrograde nail to avoid this unusual complication.

Ruptured Pseudoaneurysm of the Dorsalis Pedis Artery Following Ankle Arthroscopy: A Case Report

CASE

We describe the case of a pseudoaneurysm of the dorsalis pedis artery that developed following a repeat ankle arthroscopy for persistent osseous impingement. The patient underwent attempted fluid aspiration for a presumed effusion, and ultimately experienced rupture of the pseudoaneurysm with substantial blood loss, which required emergency vascular repair.

CONCLUSION

Anterior tibial artery and dorsalis pedis artery pseudoaneurysms are relatively rare, but they are well-documented complications of ankle arthroscopy; however, their clinical importance is poorly understood. To our knowledge, this is the first reported case of a ruptured pseudoaneurysm of the dorsalis pedis artery following ankle surgery, and it highlights the need for timely diagnosis.

Fatal complication following pure ankle dislocation in a domestic setting: case report and review of the literature

Pure ankle dislocation is a rare event that primarily results from high-energy trauma. Predisposing anatomical factors such as talar hypoplasia, ligament laxity, and previous sprains may play a key role. This report presents the case of a 55-year-old man with fatal anterior and posterior tibial artery tears following a pure anterolateral dislocation of the right ankle. To the best of our knowledge, no such cases have previously been reported in the English-language literature.

Pseudoaneurysm of the Posterior Tibial Artery following Removal of Tibial Plate- A Rare Case

Introduction:

Pseudoaneurysm is a rare complication reported after any surgery such as ORIF of fracture, plate removal, ankle or knee arthroscopy or arthroplasty. To our knowledge, pseudoaneurysms of the posterior tibial artery after tibial plate removal are a rare phenomenon. We report a case of a 18-year-old male patient who had pseudoaneurysm of posterior tibial artery following plate removal.

Case Presentation:

A 18-year-old male was referred to our outpatient clinic because of mass-like lesion in his left calf. He had a history of car accident and left isolated tibia fracture 30 months ago that was treated by open reduction and internal fixation with DCP plate. After union in radiograph, the plate was removed 7 months ago on the patient request. Four weeks after surgery, the patient had complaints of pain and swelling. Finally, pseudoaneurysm was diagnosed and was repaired in a common surgery with a vascular surgeon without any difficulty.

Conclusion:

Pseudoaneurysms of the posterior tibial artery after tibial plate removal are an extremely rare phenomenon. This complication in most cases follows penetrating injuries but it has been reported following blunt trauma. In fact, in most of these patients the diagnosis was initially missed because the large hematoma concealed the underlying pseudoaneurysm and its pulsations. Thus, a delay in the diagnosis is common in this phenomenon. Hence, the surgeon should be suspicious to this complication following plate removal when he/she is doubtful about the sign and symptoms.

Pseudoaneurysms after Ankle Sprain: Report of Three Cases Successfully Cured by Nonsurgical Treatment

Pseudoaneurysm is a rare complication of ankle sprain, with 18 case reports published in the current literature. In the vast majority of the cases, they were treated surgically. We present 3 cases of pseudoaneurysm following ankle sprain, treated by nonsurgical methods in 2 cases, and spontaneously healed in another. The diagnosis was made between 2 and 4 weeks after traumatism, by ultrasonography and arteriography in 2 cases, and only by ultrasonography in a third case. The pseudoaneurysms originated respectively from the perforating fibular artery, the dorsal pedis artery, and a lateral malleolar artery. Largest diameters of the pseudoaneurysms ranged from 2.4 to 6 cm. Patients were successfully treated by thrombin injection in a case and by coil embolization in another. Spontaneous thrombosis was demonstrated at follow-up in the third case. These cases suggest that a nonsurgical treatment can be considered for pseudoaneurysms complicating ankle sprains.

Pseudoaneurysm of anterior tibial artery following a diaphyseal fracture of the tibia mimicking a malignant bone tumor

Pseudoaneurysms of the lower limb are rare and frequently iatrogenics complications. Closed traumas are likely to generate lesions of the arterial wall, which generally become symptomatic at a later stage. The diagnosis of such vascular lesion is difficult because the symptomatology and the onset can be delayed. We herein report the case of a 15-year-old patient in whom the diagnosis of pseudoaneurysm of the anterior tibial artery was made 5 months after a non-displaced closed fracture of the tibial shaft. The radiographs were evocative of a malignant bone tumor. The study of vessels by a contrast-enhanced CT-scan enabled us to diagnose the pseudoaneurysm. Before the occurrence of late onset swelling, a history of trauma must be sought, even old.

Pseudoaneurysm of the Perforating Peroneal Artery After Ankle Fracture Fixation: Case Report and Review of the Literature

Pseudoaneurysm formation around the ankle area is a very rare complication of an anatomic region that is highly exposed to trauma. A review of the published medical data revealed the rarity of the condition. Pseudoaneurysms of the perforating branch of the peroneal artery account for only 8 in the published data, with 6 (75%) cases related to sprain injury and only 2 (25%) to fracture fixation. We present a pseudoaneurysm of the perforating peroneal artery after a bimalleolar ankle fracture in a patient taking warfarin and a review of the published data. Our patient was treated successfully with thrombin embolization, and at 6 weeks after embolization, she remained completely free of symptoms.

Pseudoaneurysms around the foot and ankle: case report and literature review

Pseudoaneurysms developing around the foot and ankle are known to be an uncommon complication following surgery. We present a case of a pseudoaneurysm following ankle surgery for a tibial plafond fracture and comprehensively review the literature with emphasis on their anatomic location, aetiology and treatment options.

Pseudoaneurysm of the Anterior Tibial Artery following Tibio-Talar-Calcaneum Fusion with a Retrograde Nail: A Rare Case and Literature Review

This study reports the case of an 87-year-old woman who presented with a nonresolving haematoma 13 weeks following tibiotalar arthrodesis surgery on her right ankle using a retrograde nail. This was revealed by angiography to be a pseudoaneurysm of the anterior tibial artery. The patient subsequently underwent endovascular stenting of the pseudoaneurysm and has had a successful recovery. This case highlights the need for awareness of both the normal arterial supply to the leg and ankle as well as the potential for anatomical variations. Arterial variation may be as high as 6.7% based on published findings from cadaveric studies. As pseudoaneurysm is a rare complication, a high index of suspicion is needed in order to avoid a missed or delayed diagnosis. We urge surgeons to keep in mind the potential for pseudoaneurysm when a patient presents with a nonresolving haematoma and arrange appropriate further investigations as needed.