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Case Reports in Orthopedics
Volume 2014 (2014), Article ID 896968, 4 pages
http://dx.doi.org/10.1155/2014/896968
Case Report

Unusual Presentation of Pseudoaneurysm with Trochanteric Fracture Femur with Associated Long-Term Antiepileptic Therapy

Department of Orthopedics, Sir Ganga Ram Hospital, New Delhi 110060, India

Received 18 March 2014; Revised 3 July 2014; Accepted 21 July 2014; Published 12 August 2014

Academic Editor: John Nyland

Copyright © 2014 Nipun Rana et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Arterial injury following impalement due to a trochanteric hip fracture-fragment per se has been documented rarely. We report a case of pseudoaneurysm of profunda femoris artery at the first perforator branch in a 48-year-old male, with trochanteric hip fracture following a fall during an epileptic episode. Persistent recalcitrant pain, globular swelling in the groin, unexplained drop in the haemoglobin level, and color doppler ultrasonography findings were salient features to the diagnosis. Additionally, we collected all reported cases of pseudoaneurysm associated with hip fractures. We reviewed the literature regarding the incidence, treatment, and prognosis for the same. Acute vascular injury was probably caused by the spikes of fractured lesser trochanter which was found to be displaced superomedially. All trochanteric fractures especially those with displaced lesser trochanter fragment should be closely watched for the possibility of vascular injury. Early diagnosis and treatment in a staged manner can prevent the catastrophic vascular event and hence the limb.