ABSTRACT
The authors describe a unique complication after manipulation of a stiff total knee arthroplasty in a 47-year-old man. Four days after undergoing manipulation under anesthesia (MUA), the patient presented with increasing pain and swelling of the affected knee and decreased hemoglobin/hematocrit. Computed tomographic angiogram revealed a ruptured pseudoaneurysm of a segmental branch of the deep femoral artery that was treated with embolization and anterior thigh compartment fasciotomy. Although many complications of MUA have been described, we present a novel finding of a ruptured pseudoaneurysm. Ruptured pseudoaneurysm should be included in the differential diagnosis whenever a patient presents with pain and swelling of the thigh after MUA given its potential morbidity.
Subject(s)
Aneurysm, False/etiology , Aneurysm, Ruptured/etiology , Arthroplasty, Replacement, Knee , Femoral Artery , Manipulation, Orthopedic/adverse effects , Aneurysm, False/diagnostic imaging , Aneurysm, False/therapy , Aneurysm, Ruptured/diagnostic imaging , Aneurysm, Ruptured/therapy , Embolization, Therapeutic , Humans , Knee Joint/physiopathology , Knee Joint/surgery , Male , Middle Aged , Osteoarthritis, Knee/surgery , Range of Motion, Articular/physiology , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
A 47-year-old man, a fine woodworker, sustained extensive phalangeal and soft tissue loss of his dominant left long and index fingers in a table saw injury. We report the long-term clinical and radiographic outcomes of the patient following reconstruction with corticocancellous iliac crest bone grafts. Rarely described in recent literature, we believe that primary nonvascularized autogenous bone grafting for phalangeal reconstruction is a worthwhile alternative to amputation when the soft tissue envelope is satisfactory.
