• Journal of the Korean Orthopaedic Association
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• v.56 no.6
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• pp.535-539
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• 2021

Vascular complications following a femoral fracture are rare but can result in serious issues. Several case studies have reported pseudoaneurysms occurring after direct trauma or the insertion of a proximal femoral nail in the case of a proximal femoral fracture. The authors encountered an 85-year-old patient treated with retrograde intramedullary nail fixation for a distal femur fracture and suffered a decrease in the hemoglobin level, swelling, and pain on the 9^th day after surgery. The authors initially attributed the temporary hematoma and pain to ordinary postoperative processes. On the 16^th day after surgery, a pseudoaneurysm originating from the descending branch of the lateral femoral convolutional artery was diagnosed and treated by percutaneous vascular embolization. After the procedure, the hemoglobin level increased, and the swelling and pain decreased.

• Archives of Plastic Surgery
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• v.37 no.5
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• pp.595-599
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• 2010

Purpose: Trochanteric pressure sores management has been improved through the development of musculocutaneous flaps. But it has many drawbacks such as donor site morbidity and functional muscle sacrifice. With the introduction of perforator flap, it is possible to use in every location where musculocutaneous perforators are present. We have reconstructed trochanteric pressure sores using perforator-based flaps from the ascending branch of lateral circumflex femoral artery. Methods: Between May of 2006 and April of 2008, we performed six cases of perforator-based flap from the ascending branch of lateral circumflex femoral artery for the coverage of trochanteric pressure sores. For identifying perforators, a line was drawn from the anterior superior iliac spine to the superolateral border of the patella as the vertical axis, from the pubis to the trochanteric prominence as the horizontal axis. In the lateral aspect of the intersection of these two axes, various flap were designed according to its defects. The flap was raised in the subcutaneous plane above the fascia and the pedicle was traced by doppler and identified. The pedicle was meticulously dissected not to injure the periadventitial tissues and transposed to the defect. The donor site was closed primarily. Results: The mean age of patients was 56.2 years. Four male and two female patients were studied. Five patients were paraplegic. The mean defect size was $6{\times}4\;cm$. The largest flap dimension was $14{\times}7\;cm$. Donor sites were closed primarily without any complications. All flaps survived completely without necrosis, hematoma or infection. There were no recurrence during the follow-up period. Conclusion: Trochanteric pressure sores using perforator-based flap from the ascending branch of lateral circumflex femoral artery can be performed safely and it would be a reliable option for coverage of trochanteric pressure sores with minimal donor site morbidity.