Journal of Emergency Practice and Trauma

Superficial femoral artery rupture after open distal third femoral shaft fracture: A case report

Document Type : Case Report

Authors

Em Thong Huynh 1
Khai Duong 1
Duy Khai Lam 1
Tung Thanh Thach 1
Duoc Minh Le 2
Bao Tu Thai Nguyen 2

1 Center for Trauma and Orthopedics, Can Tho Central General Hospital, Can Tho, Viet Nam

2 Department of Orthopedics, Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho, Viet Nam

https://doi.org/10.34172/jept.2024.12
Abstract
Objective: This case report aims to demonstrate an instance of superficial femoral artery (SFA) rupture after an open femoral shaft fracture.
Case Presentation: Our patient was a 22-year-old man admitted to the emergency department after a motorbike accident with a deformity at the distal third of the thigh and an open wound on the medial side. Radiographs and computed tomography angiography revealed a left distal third femoral fracture with ipsilateral SFA injury. We performed fracture reduction external fixation following SFA reconstruction using a 5-cm saphenous vein autograft. Prophylaxis fasciotomy was not performed. At a 6-month follow-up, the wound was well-healed, the Doppler ultrasound showed good blood flow at the reconstructed artery, and a rigid callus entirely covered the fracture.
At 1-year follow-up, the patient could walk with full weight-bearing. Maximum knee range of motion was restored, and the patient could return to daily activities.
Conclusion: Vascular injury after femoral shaft fracture is rare, and accurate diagnosis with timely and appropriate surgery plays a crucial role in achieving limb salvage, reducing the risk of complications, and improving the overall quality of patient life.

Keywords

Femoral shaft fracture
Superficial femoral artery
Rupture
Saphenous vein graft
Vascular reconstruction
Anticoagulation
Subjects
1. Sturm JT, Bodily KC, Rothenberger DA, Perry JF Jr. Arterial injuries of the extremities following blunt trauma. J Trauma.
1980;20(11):933-6. doi: 10.1097/00005373-198011000-00004.
2. Krishna SV, Sindhu B, Suhas TR, Sumanahalli CH. Femoral artery injuries in closed femur shaft fractures: case report. Surg J (N Y). 2022;8(3):e219-23. doi: 10.1055/s-0042-1756206.
3. Ball CG, Feliciano DV. A simple and rapid vascular anastomosis for emergency surgery: a technical case report.
World J Emerg Surg. 2009;4:30. doi: 10.1186/1749-7922-4-30.
4. Ge J, Kong KY, Cheng XQ, Li P, Hu XX, Yang HL, et al. Missed diagnosis of femoral deep artery rupture after femoral shaft fracture: a case report. World J Clin Cases. 2020;8(13):2862-9. doi: 10.12998/wjcc.v8.i13.2862.
5. Alarhayem AQ, Cohn SM, Cantu-Nunez O, Eastridge BJ, Rasmussen TE. Impact of time to repair on outcomes in
patients with lower extremity arterial injuries. J Vasc Surg. 2019;69(5):1519-23. doi: 10.1016/j.jvs.2018.07.075.
6. Jin L, Zhang S, Zhang Y, Lin X, Feng D, Hu K. Management algorithm of external fixation in lower leg arterial injury for
limb salvages. BMC Surg. 2022;22(1):79. doi: 10.1186/s12893-022-01486-2.
7. Fowler J, Macintyre N, Rehman S, Gaughan JP, Leslie S. The importance of surgical sequence in the treatment of
lower extremity injuries with concomitant vascular injury: a meta-analysis. Injury. 2009;40(1):72-6. doi: 10.1016/j.
injury.2008.08.043.
8. Soucacos PN, Kokkalis ZT. Fractures with arterial injury. In: Bentley G, ed. European Surgical Orthopaedics and
Traumatology. Berlin, Heidelberg: Springer; 2014. p. 179-210. doi: 10.1007/978-3-642-34746-7_19.
9. Masood A, Danawar NA, Mekaiel A, Raut S, Malik BH. The utility of therapeutic anticoagulation in the perioperative
period in patients presenting in emergency surgical department with extremity vascular injuries. Cureus. 2020;12(6):e8473.doi: 10.7759/cureus.8473.
10. Khan S, Elghazaly H, Mian A, Khan M. A meta-analysis on anticoagulation after vascular trauma. Eur J Trauma Emerg
Surg. 2020;46(6):1291-9. doi: 10.1007/s00068-020-01321-4.
11. Cannavale A, Santoni M, Cannavale G, Fanelli F. Anticoagulation in peripheral artery disease: are we there yet?
Vasc Endovasc Rev. 2020;3. doi: 10.15420/ver.2019.10.
Journal of Emergency Practice and Trauma
Volume 10, Issue 1
January 2024
Pages 70-73

  • Receive Date 08 November 2023
  • Revise Date 12 March 2024
  • Accept Date 02 April 2024

Home

Editor-in-Chief: Shahrad Tajoddini, MD

Guide for Authors

Submit Manuscript

Reviewers

Contact Us

Editorial board