Lower Limb Ischaemia Complicating Total Hip Arthroplasty

This article is about two patients having vascular injuries complicating total hip arthroplasty because of intraoperative indirect injuries. One patient had a delayed presentation of acute lower limb ischaemia, in which he required amputation of his left second toe because of ischaemic gangrene. The other patient had acute lower limb ischaemia leading to permanent muscle and nerve damage because of delayed recognition. Both patients had vascular interventions for the indirect vascular injuries. Preoperative workup for suspicious underlying peripheral vascular disease, intraoperative precautions, and perioperative period of vascular status monitoring are essential for prevention and early detection of such sinister events.

中文摘要本文記錄兩個病人在進行全髋關節置換手術中引發的間接血管受創之案例。一名患者在手術後有延遲呈現下肢缺血的併發症，因而要切除左腳的第二隻缺血壞死的腳趾。另一名患者併發急性下肢缺血症狀，並因延誤而導致下肢肌肉和神經線永久損害。這兩名患有間接血管受創者均需要血管介入治療術處理。術前對懷疑潛在周邊血管病變的診斷檢查、手術中的預防措施，以及手術前後對血管狀況的監測是預防和及早發現這些災難性的併發症必需之手段。