Pseudoaneurysm Formation due to Popliteal Artery Injury Caused by Drilling during Medial Opening Wedge High Tibial Osteotomy
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We report a case of 53yearold woman with an injured popliteal artery due to excessive drilling with a drill bit during medial opening wedge high tibial osteotomy (MOWHTO). Pseudoaneurysm was diagnosed three days after surgery and confirmed by urgent computed tomography (CT) angiography. Open vascular surgery with resection of the perivascular hematoma and endtoend anastomosis using ipsilateral saphenous vein interposition graft was performed. CT angiography at 8 months postoperatively showed that blood flow was maintained without obstruction of the graft site and active dorsiflexion of the foot was possible. To reduce neurovascular injury during MOWHTO, it is important not to drill the far cortex at the proximal part of the osteotomy site when using a drill bit, and the metal should be positioned posteromedially as much as possible.
Abstract
We report a case of 53yearold woman with an injured popliteal artery due to excessive drilling with a drill bit during medial opening wedge high tibial osteotomy (MOWHTO). Pseudoaneurysm was diagnosed three days after surgery and confirmed by urgent computed tomography (CT) angiography. Open vascular surgery with resection of the perivascular hematoma and endtoend anastomosis using ipsilateral saphenous vein interposition graft was performed. CT angiography at 8 months postoperatively showed that blood flow was maintained without obstruction of the graft site and active dorsiflexion of the foot was possible. To reduce neurovascular injury during MOWHTO, it is important not to drill the far cortex at the proximal part of the osteotomy site when using a drill bit, and the metal should be positioned posteromedially as much as possible.
참고문헌 (10)
- Han SB, "A"safe zone"in medial open-wedge high tibia osteotomy to prevent lateral cortex fracture", Knee Surg Sports Traumatol Arthrosc, 21, pp.90~95 (2013)
- Sawant MR, "Pseudo-aneurysm of the anterior tibial artery complicating high tibial osteotomy : a case report", Knee, 8, pp.247~248 (2001)
- Attinger MC, "Complete rupture of the popliteal artery complicating high tibial osteotomy", J Orthop, 11, pp.192~196 (2014)
- Bernhoff K, "Iatrogenic popliteal artery injury in non arthroplasty knee surgery", Bone Joint J, 97, pp.192~196 (2015)
- Georgoulis AD, "Nerve and vessel injuries during high tibial osteotomy combined with distal fibular osteotomy : a clinically relevant anatomic study", Knee Surg Sports Traumatol Arthrosc, 7, pp.15~19 (1999)
- Kim J, "Vascular safety during high tibial osteotomy : a cadaveric angiographic study", Am J Sports Med, 38, pp.810~815 (2010)
- Yoo JH, "The location of the popliteal artery in extension and 90 degree knee flexion measured on MRI", Knee, 16, pp.143~148 (2009)
- Saad NE, "Pseudoaneurysms and the role of minimally invasive techniques in their management", Radiographics, 25(Suppl 1), pp.S173~S189 (2005)
- Sigterman TA, "Anterior tibial artery aneurysm : case report and literature review", Int J Surg Case Rep, 4, pp.243~245 (2013)
- Boologapandian V, "Anterior tibial artery pseudoaneurysm : case series", Indian J Vasc Endovasc Surg, 4, pp.112~114 (2017)