Hip international : the journal of clinical and experimental research on hip pathology and therapy
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Vascular complications following internal fixation of trochanteric femoral fractures are extremely rare. Iatrogenic injury to the profunda femoris artery or one of its branches and resultant pseudoaneurysm formation has been documented, most commonly following sliding hip screw fixation and typically arises on the posteromedial aspect of the femur. We report an unusual variation, following proximal femoral nailing of an intertrochanteric femoral neck fracture, where the pseudoaneurysm presented four weeks following surgery on the posterolateral aspect of the femur. The mechanism of injury, clinical presentation and potential preventative measures are discussed.
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Transcranial Doppler ultrasound has been used to detect cerebral emboli after hip arthroplasty. The cognitive effects of these embolic events are unclear. The aim of this study was to assess cognitive change after primary cemented hip arthroplasty using a range of neuropsychological tests and to measure intraoperative cerebral embolic load. ⋯ A significant (p<0.01) difference was noted in specific tests assessing mental processing speed, visual searching and sustained and divided attention following surgery. Intra-operative cerebral embolic signals were detected in 11 out of 20 patients and the majority occurred with femoral component cementation and hip reduction. There was no difference in cognitive dysfunction between those patients who had detectable cerebral embolic signals and those who did not and there appeared to be no direct correlation between the size of the embolic load and the level of cognitive dysfunction.