Title : Iatrogenic superficial femoral artery thrombosis following hip surgery revision in a child with developmental dysplasia of the hip
Abstract:
Iatrogenic femoral artery thrombosis during pediatric orthopedic procedures is an uncommon but clinically significant complication due to the high risk of acute limb ischemia, limb loss, and permanent functional impairment. Surgical procedures such as open reduction for the treatment of developmental dysplasia of the hip involve manipulation of deep vascular structures, which may predispose patients to arterial injury or secondary thrombosis.
We report the case of a 4-year-old male (14 kg) with left developmental dysplasia of the hip who underwent open reduction and fixation using two pelvitrochanteric pins. In the immediate postoperative period, the patient developed coldness of the left lower limb and absence of distal pulses. Doppler ultrasonography demonstrated absence of flow in the femoral arterial system.
The patient was taken urgently to the operating room, where thrombosis of the superficial femoral artery was identified. Surgical management consisted of thromboembolectomy through a transverse arteriotomy followed by vascular repair with 7-0 Prolene sutures. Immediate restoration of arterial pulses and limb perfusion was achieved. The postoperative course was favorable, and the patient received full anticoagulation therapy without complications. At discharge, there were no signs of vascular compromise or functional sequelae.
Early recognition and prompt surgical intervention, combined with close postoperative monitoring, are essential to preserve limb viability and prevent long-term complications in pediatric patients with iatrogenic arterial thrombosis. A multidisciplinary approach involving orthopedic and vascular surgery teams significantly improves clinical outcomes in these complex cases.
