Vascular complications during ilizarov fixator surgery to the femur. Two case reports with the introduction of a method for determining the safe vascular corridor around the femur

Abstract

Aim: To perform an in-depth review of the safe vascular corridor around the femur in order to decrease possible vascular injury. Background: Despite regular use of half pins in the femur, there is no region entirely safe for percutaneous pin placement. Damage to a major nerve or vessel must be avoided at all costs. Vascular complications during Ilizarov fixator surgery to the femur are rare but serious. Case description: Of 306 cases of Ilizarov fixation to the femur in the period from 2002 to 2016, two cases had vascular complications. The first case developed a delayed superficial femoral artery (SFA) pseudoaneurysm and the second case sustained an early deep femoral artery (SFA) injury. Conclusion: The in-depth review of the vascular anatomy around the femur with relevance to the placement of half pins indicates that the femoral shaft segment greatest at risk to lead to a vascular injury lies between the two points: 8 and 24 cm proximal to the adductor tubercle.