Pseudoaneurysm of the anterior tibial artery after interlocking tibial nailing: an unexpected complication

Traumatic pseudoaneurysm of the peroneal artery following lower extremity fracture - A case report and review of the literature

This report documents a rare case of arterial aneurysm following a closed midshaft tibial and fibular fracture. Briefly, a 17-year-old female suffered a traumatic lower extremity fracture and was treated by intramedullary nailing of the tibia. After an uneventful postoperative course, she noted a painful and pulsating swelling of the lateral aspect of the lower extremity about 2 weeks post op. Diagnostic ultrasound confirmed formation of traumatic pseudoaneurysm of the peroneal artery adjacent to the fibular fracture. Subsequent endovascular treatment using coil-embolization was successful. Bony healing occurred in a timely fashion and the patient returned to pain free semi-professional sports activities.

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.

Non-invasive repair of an iatrogenic tibial artery branch pseudoaneurysm after intramedullary nailing

Tibial fractures are a commonly seen injury in orthopedic surgery. Intramedullary nailing is considered the standard of care, as complications are rare. Those of a vascular nature, including iatrogenically induced pseudoaneurysms of the tibial artery have been previously described in the literature, however each reported case has required surgical repair. In the current case, we describe a repair of a tibial artery branch pseudoaneurysm, after direct contact with an interlocking screw from tibial intramedullary nailing, via ultrasound-guided thrombin injection. To the authors' knowledge, this is the first reported case of a tibial artery pseudoaneurysm repaired non-surgically. This adds support to the promising literature on non-invasive repair of orthopedically related pseudoaneurysms.