Abstract Iatrogenic femoral artery injury is a rare complication of hip fracture surgery but may cause serious morbidity if unrecognized. The profunda femoris artery is most commonly affected because of its close anatomical relationship to the proximal femur, and pseudoaneurysm formation is the typical delayed presentation. We report a 72-year-old woman with a progressively enlarging pulsatile mass in the right groin 6 months after fixation of an intertrochanteric fracture using a dynamic hip screw and plate. Imaging demonstrated a large profunda femoris artery pseudoaneurysm measuring 170 × 107 mm, likely caused by screw tips protruding beyond the medial femoral cortex. Open surgery was performed with thrombus evacuation, pseudoaneurysm sac resection, and oversewing of the injured profunda femoris artery. Recovery was uneventful. Although uncommon, profunda femoris artery injury should be suspected in patients with unexplained thigh swelling, pain, or anemia after hip fracture surgery. Early diagnosis and appropriate imaging are essential.
Dimic et al. (Fri,) studied this question.