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Entrapment der A. tibialis anterior in einer distalen Tibiafraktur nach intramedullärer Nagelung

Entrapment of the anterior tibial artery in a distal tibial fracture after intramedullary nailing

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Zusammenfassung

Es wird ein Fallbericht über ein Entrapment der A. tibialis anterior im Rahmen der Versorgung einer distalen geschlossenen Tibiafraktur mit Hilfe eines Tibianagels präsentiert. Wegen offenen Metatarsalefrakturen mit einer schwerer Weichteilverletzung der gleichen Seite wurde nach mehreren Débridements eine freie Latissimus-dorsi-Lappenplastik zur Deckung geplant. Die präoperative Angiographie zeigte einen Verschluss der A. tibials anterior auf Frakturhöhe. Der Verschluss wurde als eine sekundäre Gefäßokklusion interpretiert, die durch eine Intimaverletzung des Gefäßes im Rahmen der Verletzung verursacht wurde. Das Entrapment der Arterie im Frakturspalt wurde erst intraoperativ während der Präparation für die Gefäßanstomosierung der Lappenplastik festgestellt.

Abstract

We present a patient with a closed displaced distal tibia fracture with entrapment of the anterior tibial vessels in the fracture after tibial nailing. This complication was initially not recognised. After several debridements of the forefoot on the same side due to open metatarsal fractures and severe soft tissue injury, a free latissimus dorsi flap was used for covering the dorsum pedis. Preoperative angiography showed occlusion of the anterior tibial artery at the fracture line which was interpreted as a secondary occlusion due to an intima lesion of the vessel after injury. The entrapment in the fracture line was recognised intraoperativelly during the preparation of the anterior tibial vessel.

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Authors and Affiliations

  1. Departement Chirurgie, Universitätsspital Zürich, Schweiz

    L. Labler

  2. Klinik für Plastische- und Wiederherstellungschirurgie, Universitätsspital Zürich, Schweiz

    V. Wedler

  3. Klinik für Unfallchirurgie, Universitätsspital Zürich, Schweiz

    L. Mica

  4. Departement Chirurgie, Universitätsspital Zürich, Schweiz

    O. Trentz

  5. Klinik für Unfallchirurgie, Universitätsspital Zürich, Rämistrasse 100, 8091, Zürich, Schweiz

    L. Labler

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  1. L. Labler
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  2. V. Wedler
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  3. L. Mica
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  4. O. Trentz
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Correspondence to L. Labler.

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Labler, L., Wedler, V., Mica, L. et al. Entrapment der A. tibialis anterior in einer distalen Tibiafraktur nach intramedullärer Nagelung. Unfallchirurg 109, 156–159 (2006). https://doi.org/10.1007/s00113-005-1033-x

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  • DOI: https://doi.org/10.1007/s00113-005-1033-x

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