Iatrogenic Arterial Injury And Foot Gangrene A Case Report

Abstract

Background: Elective orthopaedic operations on the knee is rarely complicated by arterial injury.

Report: A case report is presented of a 10year old girl that developed gangrene of the foot following an elective orthopaedic operation on the proximal tibial metaphysis. A transfixion wire that breached the posterior tibial cortex was most probably responsible for popliteal artery injury that resulted in ischaemia and gangrene. The patient had an amputation of all the toes in the affected limb and recovered satisfactory limb function.

Conclusion: In operations on the proximal tibial metaphysis, implants (screws, pins, wires) should not be allowed to perforate the posterior cortex. When this occurs inadvertently, they should be readjusted as soon as radiographs confirm this, to avoid injury to the popliteal artery.


Keywords: ischaemia, arterial injury, gangrene, amputation, orthopaedic operation

Nigerian Journal of Clinical Practice Vol. 10 (4) 2007 pp. 352-354