1. Pseudoaneurysm of Dorsalis pedis artery due to inversion injury of the ankle
- Author
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Ailene Fitzgerald, Moshe Halak, Ramesh B. Velu, and Antoinette Zwaans
- Subjects
medicine.medical_specialty ,business.industry ,Ultrasound ,Soft tissue ,medicine.disease ,Surgery ,Pseudoaneurysm ,medicine.anatomical_structure ,Aneurysm ,Dorsalis pedis artery ,medicine.artery ,Emergency Medicine ,medicine ,Orthopedics and Sports Medicine ,Ankle ,business ,Foot (unit) ,Artery - Abstract
A 22-year-old University student injured his rightankle while playing soccer. He presented with grossswelling,painaroundtheankleandnumbnessofthetoes. X-ray of the foot revealed soft tissue swellingwith no bony injury. He was initially managed withbed rest, foot end elevation, local ice packs andanti-inflammatory agents. Though most symptomssettled, the numbness in the toes persisted.Duplex Ultrasound of the ankle to grade theseverity of injury, identified a pseudoaneurysm ofthe dorsalis pedis Artery (Fig. 1). It measured3cm 5 cm and had a wide neck of 0.6 cm. Com-pression treatment was not attempted due to pain.The aneurysm was surgically explored. The dor-salis pedis artery was exposed and controlled. Sur-rounding haematoma was evacuated and the rent inthe artery identified (Fig. 2). As it involved morethan two-third the circumference of the artery, itwas transacted and an end-to-end anastomosisdone. A posterior slab was applied to immobilisethe ankle.The patient had an uneventful recovery. Heregained sensation to his toes. Ankle swellingsettled. A good pulse was felt clinically. Duplex scanconfirmed the artery to be patent during immediatepost-operative period and at 6-week follow-up.
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