Endovascular treatment of a post catheterization pseudoaneurysm: a stitch in time saves nine

External iliac artery [EIA] pseudoaneurysms are a well-known complication after arterial catheterization procedures. Most develop as a result of high femoral puncture. Small asymptomatic pseudoaneurysms are usually of no consequence but large symptomatic pseudoaneurysm carries a significant risk of rupture with serious life-threatening consequences and needs to be treated. We report here a case of EIA pseudoaneurysm in a 60 year old male patient after a cardiac catheterization procedure. CT angiography demonstrated a large pseudoaneurysm arising from the EIA and compressing the urinary bladder. Patient complained of abdominal pain and felt dizzy and required transfusions due to rapidly developing anaemia secondary to blood loss. Conventional angiography revealed free extravasation of contrast from the EIA. Percutaneous intervention through femoral access was performed by deploying a covered stent which effectively sealed off the perforation site with no evidence of contrast extravasation

Outcome of dynamic compression plate for displaced diaphyseal fractures of the radius and ulna in adults

Background: In adults displacement, angulation, rotation and comminution may be quite marked and closed reduction is often difficult or impossible to achieve. Even if an acceptable position can be obtained, and a cast successfully applied, late slipping of the fracture is extremely common and difficult to treat with severe loss of function

Objective: To assess the fracture union and functional outcome of patients treated with stable internal fixation and early mobilization

Study Design: Prospective study

Setting: Orthopaedic surgery departments of Independent Medical College and Punjab Medical College Faisalabad

Study Period: Between January 2010 and December 2011

Method: The study group included 32 males and 14 females aged 14-60 years with unstable displaced fractures shaft radius, ulna or both. Relevant history and x-rays of the forearm were taken. We followed the inclusion and exclusion criteria. All the cases were treated with open reduction and internal fixation with 3.5mm small fragment dynamic compression plate and screws. The cases were followed for at least 6 months. Patients were assessed functionally and radiologically and results were graded according to the system described by F.M. Marek et al [1961] as excellent, good, fair and poor

Results: This prospective study was completed on 46 patients 32 were male and 14 were female. All fractures were united in acceptable alignment. At final assessment excellent results were obtained in 31 [67.39%], good results in 8 [17.39%], fair in 4[08.69%] and poor in 3[06.53%] of the cases. Poor clinical out come was high in neglected and mishandled cases. There was no implant breakage or failure or fracture adjacent to 3.5 mm small fragment DCP

Conclusion: Dynamic compression plate is an excellent fixation for displaced diaphyseal fractures of the forearm bones in adults