Posterior tibial artery pseudoaneurysm after titanium elastic nailing for tibial shaft fracture in a 7-year-old boy.

BACKGROUND

Flexible intramedullary nailing is a minimally invasive method used for pediatric tibial shaft fractures stabilization.

CASE PRESENTATION: A seven-year-old boy sustained a midshaft oblique tibial fracture due to a fall from one meter height and was treated by closed reduction and intramedullary nailing. On the first postoperative day, a swelling of the proximal half of the lower leg occurred and progressed to compartment syndrome. The lower leg was edematous, firm and painful on palpation, and the pain at rest was out of proportion to injury. CT angiography showed a posterior tibial artery pseudoaneurysm and no signs of deep venous thrombosis. He was successfully treated by pseudoaneurysm evacuation and saphenous vein patch repair of the posterior tibial artery. Postoperative course was uneventful.

CONCLUSION

Vascular complications after flexible intramedullary nailing in children are rare and require early recognition. In this case, treatment by open surgical technique was successful.