Vascular Injuries

  • Peter Emil Ochsner
  • Bernhard Nachbur

Abstract

While vascular injuries during total hip replacements can be potentially life threatening, in most cases they pose at least a serious threat to the affected leg. Intraoperative injuries include open or concealed massive bleeding, which can lead to shock. Perioperative vascular thrombotic occlusions are easily overlooked because of their insidious nature. Postoperatively, pseudoaneurysms and arterioarterial emboli can result in an ischaemic syndrome in the affected leg. The most serious consequences for the affected leg are generally apparent by the end of the procedure at the latest. Since the aforementioned later occurring consequences are not acutely life-threatening, time is available for more precise diagnostic measures to be implemented.

Keywords

Vascular Injury Acetabular Component Massive Bleeding Common Femoral Artery External Iliac Artery 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Al-Salman M, Taylor DC, Beauchamp CP, Duncan CP (1992) Prevention of vascular injuries in revision total hip replacements (comment). Can J Surg 35: 261–264PubMedGoogle Scholar
  2. 2.
    Bergqvist D, Carlsson AS, Ericsson BF (1983) Vascular complications after total hip arthroplasty. Acta Orthop Scand 54: 157–163PubMedCrossRefGoogle Scholar
  3. 3.
    Bindewald H, Ruf W, Heger W (1987) Die Verletzung der Ihacal-und Femoralgefäße — eine lebensbedrohliche Notfallsituation in der Hüftprothesenchirurgie. Chirurg 58: 732–737PubMedGoogle Scholar
  4. 4.
    Bullrich A, Miltner E (1989) Tödliche Blutung bei TEP-Reimplantation. Kasuistik und rechtliche Gesichtspunkte. Unfallchirurg 92: 187–190PubMedGoogle Scholar
  5. 5.
    Fiddian NJ, Sudlow RA, Browett JP (1984) Ruptured femoral vein: a complication of the use of gentamicin beads in an infected excision arthroplasty of the hip. J Bone Joint Surg [Br] 66: 493–494Google Scholar
  6. 6.
    Freischlag JA, Sise M, Quinones-Baldrich WJ, Hye RJ, Sedwitz MM (1989) Vascular complications associated with orthopaedic procedures. Surg Gynecol Obstet 169: 147–152PubMedGoogle Scholar
  7. 7.
    Fruhwirth J, Koch G, Ivanic GM, Seibert FJ, Tesch NP (1997) Gefäßläsionen in der Hüftgelenkchirurgie. Unfallchirurg 100: 119–123PubMedCrossRefGoogle Scholar
  8. 8.
    Hwand SK (1994) Vascular injury during total hip arthroplasty: the anatomy of the acetabulum. Int Orthop 18: 29–31Google Scholar
  9. 9.
    Keating EM, Ritter MA, Paris PM (1990) Structures at risk from medially placed acetabular screws. J Bone Joint Surg Am 72: 509–511PubMedGoogle Scholar
  10. 10.
    Kirkpatrick JA, Callaghan JJ, Vandemark RM, Goldner RD (1990) The relationship of intrapelvic vasculature to the acetabulum: implications in screw-fixation of acetabular components. Clin Orthop 258: 183–190PubMedGoogle Scholar
  11. 11.
    Krenzien J, Gussmann A (1998) Arterielle Gefäßverletzungen bei Hüftprothesenimplantation. Zentralbl Chir 123: 1292–1296PubMedGoogle Scholar
  12. 12.
    Mallory TH (1972) Rupture of the common iliac vein from reaming the acetabulum during total hip endoprosthesis: a case report. J Bone Joint Am Surg 54: 276Google Scholar
  13. 13.
    Nachbur B, Meyer RP, Baumgartner J (1989) Vaskuläre Komplikationen in der Hüftgelenkchirurgie. Orthopäde 18: 552–558PubMedGoogle Scholar
  14. 14.
    Nachbur B, Meyer RP, Verkkala K, Zürcher R (1979) The mechanisms of severe arterial injury in surgery of the hip joint. Clin Orthop 141: 122–133PubMedGoogle Scholar
  15. 15.
    Neal J, Wachtel TL, Garza OT, Edwards WS (1979) Late arterial embolization complicating total hip replacement: a case report. J Bone Joint Surg Am 61: 429–430PubMedGoogle Scholar
  16. 16.
    Reiley MA, Bond D, Branick jr, Wilson EH (1984) Vascular complications following total hip arthroplasty. A review of literature and a report of two cases. Clin Orthop 186: 23–28PubMedGoogle Scholar
  17. 17.
    Schätzer A, Hellberger P, Möllers M, Stedtfeld H-W, Raithel D (1997) Arterielle Gefäßläsionen nach totalem Hüftgelenkersatz. Unfallchirurg 100: 531–535CrossRefGoogle Scholar
  18. 18.
    Shoenfeld NA, Stuchin SA, Pearl R, Haveson S (1990) The management of vascular injuries associated with total hip arthroplasty. J Vase Surg 11: 549–555Google Scholar
  19. 19.
    Siegel A, Schulz F, Püschel K (2001) Tödliche Beckenvenenverletzung durch Führungsdraht bei Anwendung der dynamischen Hüftschraube (DHS). Unfallchirurg 104: 182–186PubMedCrossRefGoogle Scholar
  20. 20.
    Stamatakis JD, Kakkar VV, Sagar S, Lawrence D, Nairn, D, Bentley PC (1977) Femoral vein thrombosis and total hip replacement. Br Med J 2: 223–225PubMedCrossRefGoogle Scholar
  21. 21.
    Todd BD, Bintcliffe IW (1990) Injury to the external ihac artery during hip arthroplasty for old central dislocation. J Arthroplasty (Suppl) 5: S53–S55PubMedCrossRefGoogle Scholar
  22. 22.
    Töndury G (1981) Angewandte und topographische Anatomie, 5th edn. Thieme, StuttgartGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2003

Authors and Affiliations

  • Peter Emil Ochsner
    • 1
  • Bernhard Nachbur
    • 2
  1. 1.Orthopädische KlinikKantonsspitalLiestalSwitzerland
  2. 2.IttigenSwitzerland

Personalised recommendations