An 85-year-old patient suffered a pertrochanteric fracture of his left femur caused
by a fall. He underwent osteosynthesis with a DYAX-nail on the day the accident took
place. During his recovery an increasing dislocation of the lesser trochanter caused
a violation of a branch of the arteria profunda femoris that required surgical intervention.
The arterial lesion was treated by embolisation successfully. An arterial lesion due
to a per- or subtrochanteric trauma that needs surgical intervention is extremely
rare, iatrogenic arterial violations are described in up to 1 % during the transfemoral
drilling procedure in order to fix common plate systems on the proximal femur. This
case report establishes for the first time a bleeding complication caused by secondary
dislocation of the lesser trochanter. In case of a per- to subtrochanteric fracture
the biomechanical advantages of an intramedullary stabilisation add to the avoidance
of transfemoral drilling in comparison to an extramedullary plate system fixed on
the femoral shaft.
Pertrochanteric femur fracture - Complication - Bleeding