572 Pseudoaneurysm of Profunda Femoris Artery in a Patient Post Dynamic Hip Screw Fixation for a Neck of Femur Fracture: A Case Report

Abstract

Abstract Background Profunda femoris artery (PFA) pseudoaneurysm as a complication of hip fracture is rare [1]. The majority of recorded cases of PFA pseudoaneurysm are caused by femur fractures, surgical operations, and penetrating trauma [2]. We present a case of PFA pseudoaneurysm following surgical fixation for neck of femur fracture with dynamic hip screw (DHS) and canulated cancellous screw. Case Presentation The patient sustained a fractured neck of femur fracture following a fall and was on long term antiplatelet therapy for ischaemic heart disease. Thery underwent surgical fixation with DHS and canulated cancellous screw but developed an unexpected drop in their haemoglobin post-op. Initial thigh ultrasound indicated a large, localised hematoma. Further investigation with CT angiography however demonstrated pseudoaneurysm of the branch of the profunda femoris artery. The patient was treated with coil embolization and was able to fully weight bear with support. Discussion Vascular injuries following hip fractures are becoming more common complications [2-4]. Pseudoaneurysms of the profunda femoris artery are an unusual but well-recognized consequence of proximal femoral fractures. When post-operative pain is unexplained, or the haemoglobin level drops, there should be a high index of suspicion for vascular injury. Ultrasound and CT angiography are useful investigations. Conclusions We present a case of pseudoaneurysm of the PFA in a patient following DHS for fractured neck of femur. This is a rare yet recognised complication of femur fractures and should be suspected where pain is increased or there is a sudden decrease in haemoglobin.