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Vascular lesions secondary to osteotomy by corticotomy.
Chir Ital. 2007 Jul-Aug; 59(4):575-9.CI

Abstract

Management of vascular traumas is frequently delayed. Vascular injuries after elective operation for bone lengthening or correction of a deformity are very'rare situations. We describe 3 cases. Case 1: male, aged 22, undergoing corticotomy for bone lengthening; immediately presented acute limb ischaemia due to a partial lesion of the popliteal artery, documented by U.S. After 7 h, direct reconstruction of the artery and fasciotomies were performed. Case 2: male, aged 27, undergoing directional osteotomy for genu varus correction. For 30 days, constant increase in leg volume and decrease in function. US showed an important haematoma at the popliteal level; arteriography documented a partial lesion of the infra-genicular popliteal artery and a voluminous false aneurysm. Direct correction of the artery and fasciotomies were performed. Case 3: male, aged 22, undergoing corticotomy for leg lengthening; immediately presented leg pain with decreased distal pulses. After 4h, there was an increase in leg volume, and arteriography showed a total lesion of the infra-genicular popliteal artery and an arteriovenous fistula. Popliteo-tibial bypass with the contralateral greater saphenous vein and fasciotomies were performed. After 1 month endovascular closure of the fistula was obtained. All patients had recovered after two months with only minor leg insufficiency. Patency of the bypass and absence of infections or delayed false aneurysms were achieved. Vascular injuries after elective orthopaedic procedures are very rare situations. Such lesions are caused by an osteotomy via corticotomy performed percutaneously. The variety of clinical presentations accounts for the difficulty in diagnosing such lesions and for the delays in implementing treatment. It is very important to obtain an early diagnosis complete with an arteriography.

Authors+Show Affiliations

UOC e Cattedra di Chirurgia Vascolare, Azienda Ospedaliera Universitaria, Messina.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

17966782

Citation

Spinelli, Francesco, et al. "Vascular Lesions Secondary to Osteotomy By Corticotomy." Chirurgia Italiana, vol. 59, no. 4, 2007, pp. 575-9.
Spinelli F, Spinelli R, Stilo F, et al. Vascular lesions secondary to osteotomy by corticotomy. Chir Ital. 2007;59(4):575-9.
Spinelli, F., Spinelli, R., Stilo, F., De Caridi, G., & Mirenda, F. (2007). Vascular lesions secondary to osteotomy by corticotomy. Chirurgia Italiana, 59(4), 575-9.
Spinelli F, et al. Vascular Lesions Secondary to Osteotomy By Corticotomy. Chir Ital. 2007 Jul-Aug;59(4):575-9. PubMed PMID: 17966782.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Vascular lesions secondary to osteotomy by corticotomy. AU - Spinelli,Francesco, AU - Spinelli,Renato, AU - Stilo,Francesco, AU - De Caridi,Giovanni, AU - Mirenda,Francesco, PY - 2007/10/31/pubmed PY - 2007/12/15/medline PY - 2007/10/31/entrez SP - 575 EP - 9 JF - Chirurgia italiana JO - Chir Ital VL - 59 IS - 4 N2 - Management of vascular traumas is frequently delayed. Vascular injuries after elective operation for bone lengthening or correction of a deformity are very'rare situations. We describe 3 cases. Case 1: male, aged 22, undergoing corticotomy for bone lengthening; immediately presented acute limb ischaemia due to a partial lesion of the popliteal artery, documented by U.S. After 7 h, direct reconstruction of the artery and fasciotomies were performed. Case 2: male, aged 27, undergoing directional osteotomy for genu varus correction. For 30 days, constant increase in leg volume and decrease in function. US showed an important haematoma at the popliteal level; arteriography documented a partial lesion of the infra-genicular popliteal artery and a voluminous false aneurysm. Direct correction of the artery and fasciotomies were performed. Case 3: male, aged 22, undergoing corticotomy for leg lengthening; immediately presented leg pain with decreased distal pulses. After 4h, there was an increase in leg volume, and arteriography showed a total lesion of the infra-genicular popliteal artery and an arteriovenous fistula. Popliteo-tibial bypass with the contralateral greater saphenous vein and fasciotomies were performed. After 1 month endovascular closure of the fistula was obtained. All patients had recovered after two months with only minor leg insufficiency. Patency of the bypass and absence of infections or delayed false aneurysms were achieved. Vascular injuries after elective orthopaedic procedures are very rare situations. Such lesions are caused by an osteotomy via corticotomy performed percutaneously. The variety of clinical presentations accounts for the difficulty in diagnosing such lesions and for the delays in implementing treatment. It is very important to obtain an early diagnosis complete with an arteriography. SN - 0009-4773 UR - https://www.unboundmedicine.com/medline/citation/17966782/Vascular_lesions_secondary_to_osteotomy_by_corticotomy_ L2 - https://medlineplus.gov/aneurysms.html DB - PRIME DP - Unbound Medicine ER -