Delayed Presentation of Sciatic Nerve Palsy Due to Post-Traumatic Pseudoaneurysm Following Pelvis Fracture: A Case Report

Document Type

Article

Publication Date

2-2023

Publication Title

Journal of Orthopaedic Case Reports

Abstract

INTRODUCTION: Pseudoaneurysms are vascular lesions occurring after injury to a blood vessel wall. Peripheral artery pseudoaneurysms as a fracture complication are uncommon and typically appear immediately after trauma or surgery. We report a unique case of sciatic nerve palsy associated with external iliac artery pseudoaneurysm arising 20 years after pelvic trauma, presenting within the fracture site as an erosive bone lesion masquerading as a possible malignancy. To the best of our knowledge, no cases of delayed external iliac artery pseudoaneurysm involving sciatic pain have been reported.

CASE REPORT: We present a 78-year-old female who sustained an acetabular fracture with an uneventful recovery for 20 years. The patient presented post-injury with symptoms and physical examination findings consistent with sciatic nerve palsy. Computed tomography angiography and duplex imaging revealed a pseudoaneurysm of the external iliac artery. The patient was taken to the operating room for endovascular repair of the external iliac artery using a covered stent.

CONCLUSION: This case of sciatic nerve palsy is a unique contribution to the literature concerning the specific vascular injury observed and the delayed presentation of pseudoaneurysm causing sciatic nerve palsy. Orthopedic surgeons must consider a wide differential when confronted with suspicious pelvic masses. Failure to diagnose these as a vascular etiology could prove catastrophic should the surgeon attempt an open debridement or sampling.

Volume

13

Issue

2

First Page

43

Last Page

47

DOI

10.13107/jocr.2023.v13.i02.3550

ISSN

2250-0685

PubMed ID

37144073

Link to Full Text

Share

COinS