A case of post-traumatic pseudoaneurysm of the peroneal artery is presented. This occurred after standard open reduction and internal fixation of a Weber type C trimalleolar fracture of the left ankle in a 33-year-old man. The pseudoaneurysm was diagnosed 12 weeks post-operatively when the patient attended the pre-assessment clinic for the removal of the syndesmosis screw. Diagnosis was confirmed on ultrasonography, and the anatomical site was confirmed by a digital subtraction angiogram. The pseudoaneurysm was coiled successfully, and the syndesmosis screw was removed in theatre the next day, without any post-operative complications. We explore the aetiology of post-traumatic peroneal pseudoaneurysms, with emphasis on the pathoanatomy and management as described in literature. This is a rare complication, but is easily manageable provided an index of suspicion is maintained.
Abu-YousefMMWieseJAShammaAR (1988) The “to-and-fro” sign: duplex Doppler evidence of femoral artery pseudoaneurysm. American Journal of Radiology150: 632–632.
2.
AlbrechtRJParraJR (2004) Traumatic peroneal artery pseudoaneurysm: use of preoperative coil embolization. Journal of Vascular Surgery39: 912–912.
3.
BandyWDStrongLRobertsT (1996) False aneurysm: a complication following an inversion ankle sprain: a case report. Journal of Orthopaedic and Sports Physical Therapy23: 272–279.
4.
HaberLLThompsonGDiDomenicoL (2008) Pseudoaneurysm of the perforating peroneal artery after subtalar joint injury: a case report. Foot and Ankle International29: 627–629.
5.
HebrangAGrgaABrkljacicB (2001) Successful closure of large pseudoaneurysm of peroneal artery using transluminal temporary occlusion of the neck with the catheter. Eur Radiol11: 1206–1209.
6.
HentonJDabisHS (2006) Pseudoaneurysm of the peroneal artery following os calcis fixation. Injury Extra37: 419–421.
7.
KurianJPillaiSCBChappleD (2003) Pseudoaneurysm of peroneal artery following ankle fracture. Journal of Foot and Ankle Surgery9: 233–235.
8.
KurihashiATamaiKSaotomeK (1994) Peroneal arteriovenous fistula and pseudoaneurysm formation after blunt trauma. A case report. Clinical Orthopedics and Related Research304: 218–221.
9.
MaguireDWHufferJMAhlstrandRA (1972) Traumatic aneurysm of perforating peroneal artery. Arterial bleeding—cause of severe pain following inversion, plantar flexion, ankle sprains. Journal of Bone and Joint Surgery [American Volume]54: 409–412.
10.
PaiVS (1999) Traumatic aneurysm of the perforating peroneal artery following ankle fracture. Journal of Foot and Ankle Surgery38: 417–419.
11.
RaineyRKAndersenCHSehornSA (1983) Traumatic false aneurysm of the ankle: a case report. Clinical Orthopedics and Related Research176: 163–165.
12.
RamdassMJ (2009) Traumatic false aneurysm of the distal peroneal artery with associated anatomic anomaly: a case report. Cases Journal2: 8605–8605.
13.
RiansCBBishopAFMontgomeryCE (1990) False aneurysm of the perforating peroneal artery: a complication of lateral ankle sprain. A case report. Journal of Bone and Joint Surgery [American Volume]72: 773–775.
14.
RozenGSamuelsDRBlankA (2001) The to and fro sign: the hallmark of pseudoaneurysm. Israeli Medical Association Journal3: 781–782.
15.
SadatUSeeTCousinsC (2007) Peroneal artery pseudoaneurysm—a case report and literature review. BMC Surgery7: 4–4.
16.
SalaFSalernoCFAlbisettiW (2013) Pseudoaneurysm of the peroneal artery: an unusual complication of open docking site procedure in bone transport with Taylor Spatial Frame. Musculoskeletal Surgery97: 183–186.
17.
SarungiMMilassinRCsfiszfirJ (1994) Arterial pseudoaneurysm of the ankle after plantar flexion-inversion injury. A rare complication and its non-invasive diagnosis. Archives of Orthopaedic and Trauma Surgery113: 349–350.
18.
SeniorHD (1919) An interpretation of the recorded arterial anomalies of the human leg and foot. Journal of Anatomy53: 130–171.
19.
StandringSWigleyCCollinsP (2006) Gray’s Anatomy. The Anatomical Basis of Clinical Practice, 39th ed. London: Elsevier Churchill Livingstone, pp. 1503–1503.
20.
SugimotoTKitadeTMorimotoN (2004) Pseudoaneurysms of peroneal artery: treatment with transcatheter platinum coil embolization. Annals of Thoracic and Cardiovascular Surgery10: 263–265.
21.
TyllianakisMPanagiotopoulosEMegasP (1995) Delayed diagnosis of a peroneal artery false aneurysm at a concomitant tibial fracture. A case report. Clinical Orthopedics and Related Research316: 211–213.
