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Pseudoaneurysm Formation from a Prominent Orthopaedic ImplantCase Report and Literature Review
Jason C. Tank, MD1; Brian G. Reilly, BA1; Anthony J. Ventimiglia, MD2; Scott D. Weiner, MD1
1 Department of Orthopaedic Surgery, Summa Health System, 444 North Main Street, Akron, OH 44310. E-mail address for J.C. Tank: jtank100@gmail.com. E-mail address for S.D. Weiner: weindersd@summahealth.org
2 Department of Radiology, Summa Health System, 525 East Market Street, Akron, OH 44309
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Investigation performed at Departments of Orthopaedic Surgery and Radiology, Summa Health System, Akron, Ohio

Disclosure: None of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of any aspect of this work. None of the authors, or their institution(s), have had any financial relationship, in the thirty-six months prior to submission of this work, with any entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. Also, no author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

Copyright © 2013 by The Journal of Bone and Joint Surgery, Inc.
JBJS Case Connector, 2013 Jun 12;3(2):e57 1-4. doi: 10.2106/JBJS.CC.M.00008
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A pseudoaneurysm occurs because of a loss of integrity of the arterial wall, resulting in blood extravasating into the surrounding soft tissues and forming an encapsulated hematoma1-6. Pseudoaneurysms can be caused by an inflammatory condition, infection, trauma, or complications of an invasive procedure5-8. The femoral artery is especially susceptible to pseudoaneurysm formation following interventional procedures (most likely because of its frequency of access). One source reported an estimated risk of 0.6% to 17%9, while another source reported an estimated risk of 8%10, which implies that the true incidence is unknown. There are few case reports in the current literature of pseudoaneurysms of the femoral artery caused by orthopaedic implants2,11-16. Femoral artery pseudoaneurysms have a variable presentation with various nonspecific symptoms, which creates a diagnostic challenge. Presentation is commonly a tense, painful, often pulsatile swelling with anemia. We present a rare case of a femoral artery pseudoaneurysm that was caused by a long proximal femoral intramedullary nail and interlocking screw that had been placed eight years earlier for fracture fixation. The patient was informed that data concerning the case would be submitted for publication, and he provided consent.
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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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