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European Journal of Trauma and Emergency Surgery

Erschienen in:

04.11.2022 | Original Article

Trochanter migrans: late complications due to displacement of the lesser trochanter in trochanteric fractures

verfasst von: Dominik Altherr, Thomas Ruffing, Katrin Schmitz, Reinhard Meier, Manfred Dahm, Alexander Hofmann

Erschienen in: European Journal of Trauma and Emergency Surgery | Ausgabe 2/2023

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Abstract

Complications associated with secondary displacement and migration of the lesser trochanter fragment in trochanteric fractures are rare. The complaints expressed by the patient may be misunderstood and attributed to implant-associated or patient-specific problems likely to occur after surgery. This series illustrates potentially dangerous late complications caused by secondary migration of the lesser trochanter. It may help focus the surgeon's attention on possible functional impairment and severe late complications caused by displacement of the lesser trochanter in trochanteric fractures that require prompt intervention.

Barquet A, Gelink A, Giannoudis PV. Proximal femoral fractures and vascular injuries in adults: incidence, aetiology and outcomes. Injury. 2015;46(12):2297–313. https://doi.org/10.1016/j.injury.2015.10.021.CrossRefPubMed

Alwhouhayb M, Howard A. A false aneurysm mistaken for a DVT after hip surgery. Ulus Travma Ve Acil Cerrahi Derg Turk J Trauma Emerg Surg TJTES. 2005;11(2):178–9.

Liu X, Liu Y, Pan S, Cao H, Yu D. Does integrity of the lesser trochanter influence the surgical outcome of intertrochanteric fracture in elderly patients? BMC Musculoskelet Disord. 2015;16:47. https://doi.org/10.1186/s12891-015-0492-7.CrossRefPubMedPubMedCentral

Sun Q, Ge W, Hu H, et al. The influence of position of the displaced lesser trochanter on clinical outcome of unstable trochanteric femur fractures in the elderly. BioMed Res Int. 2018;2018:1–6. https://doi.org/10.1155/2018/5013646.CrossRef

Schenkel M, Kaniewska M, Bühler T, Anderson S, Eid K. No difference in flexion power despite iliopsoas fatty degeneration in healed hip fractures with large lesser trochanter displacement. Eur J Orthop Surg Traumatol. 2018;28(7):1313–9. https://doi.org/10.1007/s00590-018-2200-4.CrossRefPubMedPubMedCentral

Lewin JR. The arteriographic diagnosis of a pseudoaneurysm of the femoral artery resulting from an orthopedic device. Vasc Dis. 1966;3(5):332–4.PubMed

Horton RE. Arterial injuries complicating orthopaedic surgery. J Bone Jt Surg Br. 1972;54(2):323–7.CrossRef

Dameron TB. False aneurysm of femoral profundus artery resulting from internal-fixation device (screw). J Bone Jt Surg Am J Bone Jt Surg Am. 1964;46:577–80.CrossRef

Rana N, Dhaked G, Sharma S, Tripathi S. Unusual presentation of pseudoaneurysm with trochanteric fracture femur with associated long-term antiepileptic therapy. Case Rep Orthop. 2014;2014:1–4. https://doi.org/10.1155/2014/896968.CrossRef

10.

Medlock G, McCullough L, Barker S. Femoral vein injury from a trochanteric hip fracture. Injury. 2015;46(6):1171–3. https://doi.org/10.1016/j.injury.2015.03.004.CrossRefPubMed

11.

Choa RM, Shanmugam S, Molloy A, Narayan B. Femoral vein injury in an intertrochanteric fracture: a case report. Inj Extra. 2009;40(8):155–7. https://doi.org/10.1016/j.injury.2009.04.007.CrossRef

12.

Piolanti N, Giuntoli M, Nucci AM, Battistini P, Lisanti M, Andreani L. Profunda femoris artery pseudoaneurysm after intramedullary fixation for a pertrochanteric hip fracture. J Orthop Case Rep. 2017;7(2):4.

13.

Labronici PJ, Santos Filho FCD, Diamantino YLO, Loureiro E, Ezequiel MCDG, Alves SD. Proximal femur fracture and vascular injury in adults-case report. Rev Bras Ortop. 2019;54(3):343–6. https://doi.org/10.1016/j.rbo.2017.09.003.CrossRef

14.

Abraham E, Pankovich AM, Jansey F. False aneurysm of the profunda femoris artery resulting from intertrochanteric fracture. A case report. J Bone Jt Surg Am. 1975;57(6):871.CrossRef

15.

Whitehill R, Wang GJ, Edwards JR, Stamp WG. Late injuries to femoral vessels after fracture of the hip. Case report. J Bone Jt Surg Am. 1978;60(4):541–2.CrossRef

16.

Søballe K, Christensen F. Laceration of the superficial femoral artery by an intertrochanteric fracture fragment. A case report. J Bone Jt Surg Am. 1987;69(5):781–3.CrossRef

17.

Keel JD, Eyres KS. Vascular injury by an intertrochanteric fracture fragment. Injury. 1993;24(5):350–2. https://doi.org/10.1016/0020-1383(93)90065-e.CrossRefPubMed

18.

Murphy PG, Geoghegan JG, Austin O, More-O’Ferrall R, Quinlan WR, Keaveny TV. Pseudoaneurysm of the profunda femoris artery due to intertrochanteric fracture of the hip. Arch Orthop Trauma Surg. 1999;119(1–2):117–8. https://doi.org/10.1007/s004020050372.CrossRefPubMed

19.

Nielsen KD, Dammen I. Late symptoms after hip fracture with displacement of the lesser trochanter—a case report. Acta Orthop Scand. 2003;74(4):500–1. https://doi.org/10.1080/00016470310017866.CrossRefPubMed

20.

Bernstein I, Geks J, Walthers EM, Schnabel M. False aneurysm and bleeding caused by a secondary dislocated lesser trochanter fragment. Unfallchirurg. 2004;107(12):1192–5. https://doi.org/10.1007/s00113-004-0791-1.CrossRefPubMed

21.

Rommelmann P. Compression of the femoral nerve by a secondarily dislocated fragment of the lesser trochanter following pertrochanteric fracture of the femur. Unfallchirurg. 2007;110(7):645–7. https://doi.org/10.1007/s00113-007-1290-y.CrossRefPubMed

22.

Ritchie ED, Haverkamp D. False aneurysm of the profunda femoris artery, a rare complication of a proximal femoral fracture. Acta Orthop Belg. 2007;73(4):530–2.PubMed

23.

Popovic D, Stankovic S. Deep femoral artery injury caused by non-fixed lesser trochanter 1 month after osteosynthesis. Injury Extra. 2008;39(10):337–40. https://doi.org/10.1016/j.injury.2008.06.011.CrossRef

24.

Lohmann H, Esenwein S, Geier B, Vogel T, Kleinert H. False aneurysm of the deep femoral artery due to pertrochanteric fracture of the hip with displaced fragment of the lesser trochanter. Z Orthopadie Unfallchirurgie. 2009;147(1):23–5. https://doi.org/10.1055/s-2008-1039115.CrossRef

25.

Tomčovčík L, Kováč P, Daňo J, Čuha R. Late laceration of the superficial femoral artery by an intertrochanteric fracture fragment. Hip Int J Clin Exp Res Hip Pathol Ther. 2011;21(2):273–5. https://doi.org/10.5301/HIP.2011.6512.CrossRef

26.

Jack N. Helleman, Vos DI, van der Laan L. Pseudoaneurysm of the deep femoral artery after pertrochanteric hip fracture: a case report. Vasc Dis Manag. 2011;8:E119–E120. https://www.hmpgloballearningnetwork.com/site/vdm/content/pseudoaneurysm-deep-femoral-artery-after-pertrochanteric-hip-fracture-case-report.

27.

Osagie L, Gallivan S, Pearse Y. Profunda femoris injury following lesser trochanter displacement: complications following intramedullary femoral nailing. Injury. 2015;46(2):411–3. https://doi.org/10.1016/j.injury.2014.09.021.CrossRefPubMed

28.

Regus S, Lang W. Arterial injury and pseudoaneurysm formation after lesser trochanter fracture. Int J Surg Case Rep. 2015;14:4–6. https://doi.org/10.1016/j.ijscr.2015.06.033.CrossRefPubMedPubMedCentral

29.

Neubauer Th, Grechenig St, Leitner L, Auffarth A, Plecko M. Vascular complications in plating of the proximal femur: review. Arch Orthop Trauma Surg. 2016;136(4):539–51. https://doi.org/10.1007/s00402-015-2406-4.CrossRefPubMed

30.

Lee PYF, Rao PVR, Golding DM, Brock J. Delayed profunda femoris artery bleeding after intramedullary nailing of an unstable intertrochanteric fracture: a case report. JBJS Case Connect. 2017;7(3): e60. https://doi.org/10.2106/JBJS.CC.16.00217.CrossRefPubMed

31.

Kanovsky A, Mueller EJ, Miller E. Secondary profunda femoris artery injury after intramedullary femoral nailing in a geriatric pertrochanteric femur fracture: case report. Eur J Orthop Surg Traumatol. 2019;29(8):1811–4. https://doi.org/10.1007/s00590-019-02500-9.CrossRefPubMed

32.

de Raaff CA, van Nieuwenhuizen RC, van Dorp TA. Pseudoaneurysm after pertrochanteric femur fracture: a case report. Skeletal Radiol. 2016;45(4):575–8. https://doi.org/10.1007/s00256-015-2315-1.CrossRefPubMed

Titel: Trochanter migrans: late complications due to displacement of the lesser trochanter in trochanteric fractures
verfasst von: Dominik Altherr
Thomas Ruffing
Katrin Schmitz
Reinhard Meier
Manfred Dahm
Alexander Hofmann
Publikationsdatum: 04.11.2022
Verlag: Springer Berlin Heidelberg
Erschienen in: European Journal of Trauma and Emergency Surgery / Ausgabe 2/2023
Print ISSN: 1863-9933
Elektronische ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-022-02143-2

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