PSEUDOANEURYSM OF THE SUPERFICIAL FEMORAL-ARTERY - AN UNUSUAL COMPLICATION FOLLOWING ROTATIONPLASTY

A 21 year old man presented with pain and swelling around the right kn ee. Staging studies and open biopsy provided a diagnosis of malignant fibrous histiocytoma, stage II B.(3) A wide local excision followed by prosthetic reconstruction was not possible because of extensive invol vement of the quadriceps muscle with tumor. Therefore the patient unde rwent wide local excision of the tumor and rotationplasty, providing f unctionally a transtibial amputation. Postoperatively (Day 44) a criti cal ischaemia of the foot developed, and angiography revealed a pseudo aneurysm of the superficial femoral artery at the level of the tibial condyle. The patient underwent successful arterial reconstruction and the bones united. The etiology of this pseudoaneurysm appears to be re lated to the presence of the coiled superficial femoral artery abuttin g the medial tibial condyle flare. This complication may be prevented by ensuring that the condylar flare be contoured, and then an adequate cushion of soft tissue be interposed between artery and bone at this level.