Introduction: Interlocking tibia nail fixation for tibia shaft fracture treatment is one of the most commonest procedures performed in orthopedic trauma practices. We report one such case of a rare complication of anterior tibial artery (ATA) pseudo-aneurysm caused by the proximal coronal locking bolt performed by an unusual entry from lateral to medial side during shaft of tibia fracture fixation.

Case Report: A 86- years old female sustained a road traffic accident and was diagnosed with a closed tibia shaft fracture of the right leg for which she underwent intramedullary interlocking nail IMIL nailing elsewhere. She presented to us three 3 weeks after primary surgery with persistent pain and swelling in the right leg proximally. We investigated and diagnosed her as having a pseudoaneurysm of the Anterior Tibial Artery on color Doppler and magnetic resonance imaging (MRI) angiography. The pseudoaneurysm of ATA was clipped without any complications. To avoid the rupture of the pseudoaneurysm during manipulation of nail and bolts, their positions were not changed as they were supporting the fracture well and the fracture was also not united at that time.

Conclusion: Though Although interlocking nailing of tibia shaft fracture is a commonly performed procedure, it can lead to disastrous vascular complications if the procedure is not performed with utmost care. ATA injury by proximal locking bolts of the tibia nail mandates the need for reconsideration of the nail design with better screw hole positions. We recommend preferring standard AO manual instructions for proximal tibia locking bolt direction.

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8576776PMC
http://dx.doi.org/10.13107/jocr.2021.v11.i07.2302DOI Listing

Publication Analysis

Top Keywords

anterior tibial
12
tibial artery
12
tibia shaft
12
shaft fracture
12
tibia nail
8
locking bolt
8
tibia
7
fracture
6
nail
5
iatrogenic anterior
4

Similar Publications

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!