Iranian Heart Journal

Iranian Heart Journal

Posterior Tibial Artery Pseudoaneurysm following Orthopedic Surgery: a Rare Complication

Document Type : Case Report

Abstract
Increase in trauma and aging in recent decades has been associated with an increase in orthopedic
operations in the limbs and their concomitant iatrogenic vascular complications. Although vascular
injuries during orthopedic operations are uncommon, timely diagnosis and treatment is essential.
These injuries can occur due to laceration, compression, or traction of the vessels in proximity to
bony structures such as vertebrae, hip and knee joints, and long bones. Primary signs are bleeding
or ischemia. The best results will be obtained with prompt diagnosis and treatment; otherwise, there
is a risk of complications such as pseudoaneurysm or limb loss.
The presented case is a 22-year-old male with a history of right tibial fracture following a
motorcycle accident one year before, which was treated with internal plate fixation. Following the
operation, an enlarging mass developed in the posterior aspect of his leg. Upon evaluation, it was
noted that a screw used for internal fixation had injured the posterior tibial artery and led to tibial
artery pseudoaneurysm. Surgical treatment was done. Such a complication has not been reported in
the literature. In the presence of even minimal ischemia following bone trauma, vascular evaluation
and angiography before any orthopedic operation is critical, and it is recommended that
management in such cases be performed in centers where reconstructive vascular surgery is
available(Iranian Heart Journal 2008; 9 (1):55 -60).
Keywords
pseudoaneurysm ■ complication ■ internal fixation ■ fractures
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Iranian Heart Journal
Volume 9, Issue 1
Winter 2008
Pages 55-60