背景:膝关节错位会增加骨关节炎的风险。截骨术可以矫正肢体畸形,但是它们伴随着并发症的风险,例如皮质铰链骨折,硬件故障,疼痛综合征,和感染。血管损伤是罕见的,但它会导致出血,肢体缺血,和肿胀。如果血运重建延迟超过12小时,这可能会导致糟糕的结果。报告的工作符合SCARE标准。
方法:一名41岁女性接受了股骨远端外侧闭合楔形截骨术。术后,未检测到远端脉搏.紧急血管外科会诊显示,pop静脉穿透和pop动脉血栓形成,可能在针脚穿透期间。进行了血运重建,患者出院,无并发症。在为期三年的随访中,病人身体健康,无并发症。
结论:了解股动脉和静脉与楔形尖端的接近度在外侧闭合楔形远端股骨截骨术中至关重要。尽管摆动锯造成血管损伤,它可以在导销插入过程中发生。虽然术中大量出血可显示血管损伤,缺乏它不是一个保护因素。
结论:在插针过程中,重要的是要确保销的方向是直接外侧内侧。这应该通过获取AP使用C-Arm进行检查,Lat,和倾斜的观点。为了检查术中出血,止血带应该放气。一旦程序完成,通过仔细检查远端脉搏和肢体灌注来检查任何血管损伤是很重要的,特别是在恢复室。
BACKGROUND: Knee malalignment can increase the risk of osteoarthritis. Osteotomies can correct limb deformities, but they come with the risk of complications such as cortical hinge fracture, hardware failure, pain syndrome, and infection. Vascular injury is rare, but it can lead to bleeding, limb ischemia, and swelling. If
revascularization is delayed for over 12 h, it can result in poor outcomes. The work has been reported in line with the SCARE criteria.
METHODS: A 41-year-old female underwent a lateral close-wedge distal femoral osteotomy. Postoperatively, no distal pulse was detected. An emergency vascular surgery consultation revealed popliteal vein penetration and popliteal artery thrombosis, probably during pin penetration.
Revascularization was performed, and the patient was discharged without complications. At the three-year follow-up, the patient was in good health and without complications.
CONCLUSIONS: Knowledge of the femoral artery and vein\'s proximity to the apex of the wedge is crucial in lateral close wedge distal femoral osteotomy. Despite vascular injury with an oscillating saw, it can happen during guide pin insertion. Although Intraoperative massive bleeding can show vascular injury, lack of it was not a protective factor.
CONCLUSIONS: During the process of pin insertion, it is important to ensure that the pin\'s orientation is directly lateral to the medial. This should be checked using the C-Arm by obtaining AP, Lat, and Oblique views. To check for intraoperative bleeding, the tourniquet should be deflated. Once the procedure is complete, it is important to check for any vascular injury by examining distal pulses and limb perfusion carefully, particularly in the recovery room.