Late-onset bleeding due to displaced lesser trochanter after a short gamma nail: a case report

An 89-year-old female patient presented to the emergency department with a spontaneously occurring and rapidly increasing swelling and pressure pain in her left thigh. Five weeks previously, she had suffered a pertrochanteric femur fracture on the left side following a domestic fall, which was surgically treated with a short gamma nail. Following an uneventful post-operative course, the patient was discharged to a rehabilitation clinic. A CT angiography confirmed the clinical suspicion of bleeding, identifying the profunda femoris artery as the source. The cause of the vascular injury was the displaced lesser trochanter. By implanting a covered stent, the active bleeding was stopped, and after stabilizing the patient, the hematoma was surgically removed, whereby the lesser trochanter was left alone.