External iliac artery thrombosis associated with the ilio-inguinal approach in the management of acetabular fractures: a case report

Journal of Medical Case Reports
Kajetan KlosThomas Mückley

Abstract

The ilio-inguinal approach has come to be used routinely in the management of acetabular fractures involving the anterior wall. Thrombotic complications following surgery via this route are a serious, but rare, complication. We report the case of a 66-year-old male patient who slipped on an icy pavement and fell on his left hip. He sustained a comminuted acetabular fracture (a transtectal T-fracture with an incomplete posterior stem through the ischial tuberosity), and was operated on five days later, via an ilio-inguinal approach. In the recovery room, his left lower limb was found to be cool and pale. Immediate re-exploration showed a left external iliac artery thrombosis, and thrombectomy was performed. In the surgical management of acetabular fractures, thrombosis of a major pelvic artery is a rare but potentially devastating complication. We discuss the possible aetiology (initial vessel trauma versus iatrogenic, intraoperative arterial injury) and pathomechanism, and wish to draw attention to this complication and to recommend ways in which it can be prevented. We recommend circulation monitoring in patients with acetabular fractures, especially where nerve blocks and/or deep sedation/analgesia have been used. High-risk p...Continue Reading

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Citations

Jan 17, 2015·Indian Journal of Orthopaedics·Narender Kumar MaguSs Lohchab
May 15, 2015·Expert Opinion on Biological Therapy·Anne RübsamUwe Pleyer
Mar 21, 2015·American Journal of Clinical Dermatology·A Razzaque Ahmed, Shawn Shetty
Oct 24, 2019·Archives of Orthopaedic and Trauma Surgery·Norio YamamotoToshifumi Ozaki
Dec 21, 2019·Indian Journal of Surgical Oncology·Wan Fatihah Wan SohaimiNur Asma Sapiai
Dec 4, 2012·Dermatology and Therapy·Labib R ZakkaA Razzaque Ahmed
Dec 4, 2019·Best Practice & Research. Clinical Anaesthesiology·Ivan UritsAlan David Kaye

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